THE EFFICACY OF PLATELET TO LYMPHOCYTE RATIO AND NEUTROPHIL TO LYMPHOCYTE RATIO FOR DETECTION OF NEONATAL SEPSIS IN FULL TERM NEWBORN | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 5, Volume 26, Issue 2, April 2023, Page 3327-3341 PDF (160.29 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2023.297283 | ||||
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| Abstract | ||||
| Background: Neonatal sepsis (NS) is one of the major causes of morbidity and mortality in neonatal age. NS classified according to time of symptoms in to Early-Onset Sepsis (EOS) and Late-OnsSepsis (LOS). In the new studies, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio have been used in determining the existence and severity of sepsis. This ratio is a sign of inflammation, and it can be used in foreseeing septicemia. Objectives: We aimed to evaluate efficacy of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) as a diagnostic adjunct test for detection of neonatal sepsis in full term newborn Patient and methods: This study was carried out on 96 full term neonates at the Neonatal intensive care unit (NICU) of Bab Al-sharia hospital. They were divided into two groups: group1 (patients’ group) which include 48 full term neonates’ sepsis and group 2 (controls group) which include 48 full term healthy neonates. Complete history taking, complete clinical examination and laboratory investigation as complete blood count (CBC), C-reactive protein (CRP), blood culture, immature to total neutrophil ratio (I/T ratio), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were done. Result: There were no significant differences between the study groups as regarding sex, age, mode of delivery, Gestational age, Birth weight, as regard vital data patients’ group had higher RR and HR. Respiratory distress, tachycardia, feeding intolerance, temperature instability were the most common clinical signs of septic neonate. There was a significant difference between patients and controls as regard CBC parameters (HB, PLT, TLC, Absolute lymphocytic count (ALC), Absolute neutrophil count (ANC) and I/T ratio). Patient group had significantly lower HB and platelet, higher I/T ratio, ANC, NLR and PLR compared with the controls group. As regard blood culture, Klebsiella was the most common organism followed by E.coli. An NLR of >0.82 was determined as the predictive cut off value of neonatal sepsis (sensitivity 93.8%, specificity 89.6% and p < 0.001*). An PLR of >40 was determined as the predictive cut off value of neonatal sepsis (sensitivity 60.4%, specificity 70.8% and p=0.044*). Conclusion: The study showed that neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are reliable predictive markers in the early detection of neonatal sepsis as well as high sensitivity and specificity as diagnostic markers for neonatal sepsis. | ||||
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