Ref Number = PITIKA-ASPR0224
Muhammad Ifan Romli, Tetty Yuniati
Background: In developing countries, neonatal sepsis is one of major cause of death. Clinically difficult to diagnose, and the gold standard diagnosis is from blood culture, but it needed 3-5 days for the result. To reduce the mortality and morbidity of patients, an early diagnostic is important. Because of health insurance policy in Indonesia cover Immature to total neutrophil ratio (I/T ratio) and C Reactive Protein (CRP) as a routine laboratory exam, it can be used as early marker for diagnosis of neonatal sepsis. 
Objective: This study aimed to determine sensitivity, spesificity, positive predictive value, and negative predictive value  of I/T ratio and CRP for diagnosis of sepsis neonatorum treated in the Neonatal Unit of Hasan Sadikin General Hospital. 
Methods: Data used in this study is patients clinically diagnosed as sepsis neonatorum treated in the Neonatal Unit of Hasan Sadikin General Hospital. This study was conducted using consecutive sampling during Januari – Februari 2019. Results of I/T ratio and CRP with determined  cut- off point compared with the blood culture results as golden standard for sepsis diagnostic.
Results: The results showed that the characteristics of the neonatal sepsis suspect in accordance with age is early neonatal (0-6 h), which amount to 54 (55%). Late Onset Neonatal Sepsis (LONS) classification of sepsis group at 44 (45%). The diagnostic value of I/T Ratio examination are sensitivity 55%, specificity 82%, positive predictive value 42%, negative predictive value 89%, and accuracy of 77,5%. The diagnostic value of CRP examination are sensitivity 66%, specificity 27,5%, positive predictive value 17%, negative predictive value 78%, and accuracy of 35%. As the result, we obtain CRP cut off the recommended point  is ?1,02 mg/dl and I/T ratio ?0.5.
Conclusion: CRP and I/T-ratio determination are of limited value as diagnostic tests in neonatal sepsis. More study about the use of CRP and I/T ratio with other marker for sepsis neonatal to determine the best laboratory exam for predicting neonatal sepsis.
Keywords: sepsis, neonatal, I/T ratio, crp
Keywords: sepsis, neonatal, I/T ratio, crp
Disclaimer: The Views and opinions expressed in the articles are of the authors and not of the journal.
Journal Office
Mid City Hospital, 3-A Shadman II
Jail Road, Lahore ,Pakistan
Managing Editor
Dr. Digant D Shastri
Support & Help
Associate Editor
Dr. M. Faheem Afzal
Support & Help
e-Journal Administrator
Dr. Khalid Masud