DGENERATIVE CHANGES IN NEUTROPHILS-AN INDICATOR OF BACTERIAL INFECTION

In 157 neonates in whom a sepsis work-up was performed, 195 peripheral blood smears were reviewed. Neutrophil degenerative changes (vacuolization and toxic granulation) were seen frequently in culture proven bacterial sepsis. Seventeen of 21 peripheral blood smears from neonates subsequently proven to have bacterial infection had vacuolization in neutrophils for a sensitivity of 81%, specificity of 93% and positive predictive accuracy of 59%. Comparison of relative values for predicting neonatal bacterial infection utililizing five items from a single blood sample are shown in the table: Vacuolization and toxic granulation of neutrophils are often found in the peripheral blood smear of neonates with bacterial infection and appear to be more reliable indicators of septicemia than traditional tests.