OBJECTIVE: Neonatal sepsis still remains as a challenging issue, due to sophisticated and time consuming tests needed to confirm its diagnosis. The present study aimed to assess the applicability of Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) as diagnostic markers in neonatal sepsis.
METHOD: Cross-sectional study was conducted in Neonatology Ward of R.D. Kandou General Hospital Manado from June 2018 to March 2019. Consecutive sampling method were obtained from all neonates with suspected sepsis. Neonatal sepsis is de?ned based on at least 2 clinical and 2 laboratory criteria. The NLR was calculated as the ratio of neutrophil count to lymphocyte count. The PLR was calculated as the ratio of platelet count to lymphocyte count. Initial laboratory investigations included Complete Blood Count (CBC). Data were encoded using receiver operating characteristic curve analysis.
RESULTS: A total of 85 term neonates were included in the study. Of these, 51 sample were diagnosed with sepsis neonatorum and 34 were non-sepsis. The mean NLR in sepsis and non-sepsis groups was 1.21 (95% CI, 0.78 – 1.63) and 3.26 (95% CI, 2.17 – 4.35). An NLR of 1.51 was determined as the predictive cutoff value of sepsis neonatorum (sensitivity 88.2%; speci?city 80.4%; area under the receiver-operating characteristic curve 0.859). The mean PLR in sepsis and non-sepsis groups was 44.81 (95% CI, 24.30 – 65.31) and 65.38 (95% CI, 50.86 – 79.90). A PLR of 33.38 was determined as the predictive cutoff value of sepsis neonatorum (sensitivity 79.4%; speci?city 74.5%; area under the receiver-operating characteristic curve 0.787).
CONCLUSION: NLRs and PLRs can be used as diagnostic adjunct tests for neonatal sepsis workup.