CYTOLOGICAL STUDY OF GASTRIC ASPIRATE IN NEONATAL SEPTICAEMIA

Background: Septicaemia refers to systemic disease associated with the presence and persistence of pathogenic microorganisms or their toxins in the blood. According to the data from National Neonatal perinatal database, incidence of sepsis is 3% in live births. Klebsiella, S.aureus and E.coli as the predominant bacteria isolated causing sepsis. Respiratory distress is most common presenting symptom. Examination of gastric aspirate has been used in the newborn for neonatal infection. The presence of more than five polymorphs per high power field is co-relate with increased risk of neonatal infection. Aims and Objectives: To study correlation between positive gastric aspirate and development of early onset septicaemia, prompt and proper management to prevent septicaemia at early stage and to reduce mortality rate by early diagnosis of septicaemia. Material and Methods: This prospective study was carried out at NICU of a tertiary care hospital during period from January 2012 to November 2012. 100 neonates were included in this study that were at risk for development of early onset septicaemia. Results:Out of these 100 neonates, 55 were positive for blood culture and 45 were negative for blood culture,gastric aspirate examination was positive in 38 patients and negative in 62 patients,64 neonates were preterm and 36 were full term, 27 neonates were positive for C – reactive protein and 73 were negative. Septicaemia is more common in upper lower and lower socioeconomic class. Present study show 14% mortality rate. Conclusion:Blood Culture is the gold standard for diagnosis of septicaemia and should be performed in all cases of suspected sepsis. CRP along with total leucocyte count, I/T ratio, band cells has sensitivity of 100% and specificity of 83%. Gastric aspirate examination is not a 100 % sensitive screening test but it may be helpful in high risk neonates. But with the help of gastric aspirate and various methods available, we can diagnose septicaemia up to 99.99% cases.