Platelet to Lymphocyte ratio and Neutrophil to Lymphocyte ratio as new diagnostic markers for detection of Early-onset Neonatal Sepsis in Full-term newborns

Abstract

Introduction: Neonatal sepsis is a significant cause of morbidity and mortality among newborn infants. It is divided into early-onset sepsis (EOS) and late-onset sepsis. Numerous sepsis biomarkers have been evaluated for early detection of neonatal EOS but there is no single biomarker that fulfills all essential criteria. The neutrophil to lymphocyte ratio (NLR) , because it combines neutrophils and lymphocytes in the calculation, is considered comparatively more stable than the absolute counts described above. Aim of the work: This is a prospective cross-sectional study aims to assess the Platelet to Lymphocyte ratio (PLR) and the Neutrophil to Lymphocyte ratio (NLR) in term neonates with early-onset sepsis (EOS) and compare it with healthy controls. Subjects & methods: The present study is a prospective cross-sectional study, was conducted on 80 neonates delivered in Obstetrics and Gynecology department, Minia University Children and Maternal hospital and admitted in our neonatal intensive care unit and the others during follow up in our NICU, during the period from July 2018 to January 2019. This study was performed with aim of assessment of the Neutrophil to Lymphocyte ratio (NLR) and the Platelet to Lymphocyte ratio (PLR) in term neonates with early-onset sepsis (EOS) ,and compare it with healthy matched controls. Results: NLR and PLR as predictors of early-onset neonatal sepsis, sensitivity of NLR was 67% and PLR was 70% and specificity of NLR was 99% and PLR was 73% and PPV of NLR was 98%, PLR was 72%. Conclusion: NLR, PLR are strong positive diagnostic markers in detecting early onset neonatal sepsis as PPV of NLR was 98%, PLR was 72%. Regarding to laboratory findings, Leucocytosis, thrombocytopenia, high CRP, high Procalcitonin and positive blood culture were associated with risk of neonatal sepsis.