Neutrophil volume, conductivity, and scatter (VCS) as a screening tool in neonatal sepsis

Abstract

Background The aim of the study is to establish changes in Neutrophil volume, conductivity, and scatter (VCS) in neonatal sepsis and to determine appropriate cutoff levels to be used as a screening tool for neonatal sepsis. Methods This prospective observational study was conducted at the Neonatal Intensive care Units at Ain Shams University. It included 25 septic neonates diagnosed based on the presence of risk factors of sepsis, clinical or laboratory evidence suggestive of sepsis, and positive blood culture results. A control group of 25 age-matched neonates was also included. Blood counts were processed in the automated hematology analyzer, Beckman coulter LH 750. Neutrophil VCS Parameters were analyzed and correlated with different clinical and laboratory data of the study sample. Results In this study, the value of mean neutrophil volume (MNV) was significantly increased, and the value of mean neutrophil scatter (MNS) was significantly decreased in the septic group compared with the control group, with P value = 0.026 and 0.025, respectively. The MNV showed a sensitivity of 96%, a specificity of 48%, a PPV of 64.9%, an NPV of 92.3%, and a cutoff point of >140.2 with AUC of 0.713. The MNS showed a sensitivity of 68%, a specificity of 92%, a PPV of 89.5%, a NPV of 74.2%, and a cutoff point of ≤129.4 with an AUC of 0.718. Conclusion Although neutrophil VCS parameters cannot be used alone to diagnose or rule out neonatal sepsis, they aid as additional markers for early diagnosis of neonatal sepsis. They can also be used in combination with other hematological screening tests to improve the diagnostic accuracy of the neonatal sepsis screen.