Neutrophil and Platelet to Lymphocyte Ratio for Detecting Early-onset Neonatal Sepsis

Background: Neonatal sepsis [NS] is associated with severe morbidity and mortality. Clinical manifestations range from subclinical infection to severe local or systemic infection. The diagnosis of NS remains a challenge as it has subtle and distinct signs and symptoms. Although blood culture is the gold standard in the diagnosis of NS, the search for high-sensitivity NS markers continues to overcome the drawbacks of blood cultures. The aim of the work: This study aimed to investigate the effectiveness of the neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in predicting early onset sepsis in neonates.Patients and Methods: A case control study, comprised 120 newborns [60 newborns with neonatal sepsis as a case group and 60 healthy newborns as a control group], based on patient records at neonatal intensive care unit [NICU] of Al-Azhar University Hospital [Damietta], from January 2018 to January 2019. All were subjected to adequate history taking, full clinical examination, complete blood picture, C-reactive protein and blood culture. After that, neutrophil to lymphocyte ratio [NLR] and platelet to lymphocyte ratio [PLR] were calculated. Results: NLR was significantly higher in neonates with sepsis. However, there were no association between PLR and early onset sepsis [EOS]. Although, the diagnostic cutoff value for NLR was 1.0 with 72% sensitivity, 100% specificity, there was no association between PLR and EOS.Conclusion: NLR increases significantly in neonatal sepsis, and can be used as a marker for detection of early onset neonatal sepsis.