ArticleIntensive care medicine. Paediatric and neonatal2026
Development and validation of a diagnostic model for late-onset neonatal sepsis using the haematological profile: a retrospective cohort study.
Article in Intensive care medicine. Paediatric and neonatal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Neonates admitted to intensive care units are at high risk of hospital-acquired infections. While blood cultures remain the gold standard for sepsis diagnosis, they do not detect infection in every case. Host immune response markers, such as C-reactive protein and procalcitonin, can assist in earlier detection but also have limitations and carry additional costs. We have developed a Neonatal Intensive Care Infection Score (NICIS), which leverages extended complete blood count (CBC+Diff + EIP) parameters, which may require specific analyser configuration or software licensing, to extract additional diagnostic value. Methods: We conducted a retrospective cohort study of neonates admitted to the Neonatal Intensive Care Unit at the John Radcliffe Hospital (Oxford, UK) over one year. Eighteen CBC+Diff + EIP parameters were initially considered based on their ability to differentiate culture-positive patients from those without clinical suspicion of infection. NICIS was developed as a weighted score and validated internally using a temporally distinct dataset and externally using a four-year retrospective cohort from Erasmus University Medical Center (Rotterdam, The Netherlands). Results: Incorporating eight CBC+Diff + EIP parameters, NICIS values ranged from 0 to 25, with higher scores indicating a greater likelihood of sepsis. NICIS achieved an area under the curve of 0.906 in training, 0.879 in internal validation, and 0.841 in external validation, outperforming C-reactive protein and total white blood cell count in all datasets. Conclusions: NICIS provides an interpretable tool for sepsis detection using routinely collected CBC+Diff + EIP data without additional sampling. Its performance across internal and external cohorts suggests sufficient diagnostic accuracy, although prospective studies are warranted to further assess generalisability and clinical utility. Supplementary Information: The online version contains supplementary material available at 10.1007/s44253-026-00121-9.
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