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Neonatal Sepsis Occurs With Normal CBC

Babies can develop Early Onset Sepsis (EOS) immediately after birth, yet Complete Blood Cell Count test results (CBC) can remain normal. Although certain abnormalities in CBC  were very specific for EOS, many babies had EOS with bacteremia and a normal CBC. A normal CBC cannot rule out EOS and clinical suspicion must be relied upon in order to start antibiotic treatment early and prevent serious injuries to the baby. Unfortunately, only 2,164 (1%) out of 166,092 babies with clinically suspected EOS actually had bacteria in the bloodstream, urine or cerebrospinal fluid. This study shows that doctors cannot rely on the CBC to diagnose babies with EOS, because a normal blood count does not rule it out. This means that a large number of babies still need to be treated empirically with antibiotics when there is suspicion of sepsis, even though most of them will not have bacteremia. A normal blood test is not a reason to withhold antibiotics if there are worrisome clinical signs.

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