Neutrophil-to-Lymphocyte Ratio as an Alternative Marker of Neonatal Sepsis in Developing Countries
Objectives: We sought to analyze the neutrophil-to-lymphocyte ratio (NLR) as an alternative marker of neonatal sepsis. Methods: In this cross-sectional study, we undertook consecutive sampling in all inborn neonates admitted to the Neonatal Intensive Care Unit with clinical manifestations of neonata...
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| Format: | Article |
| Language: | English |
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Oman Medical Specialty Board
2021-01-01
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| Series: | Oman Medical Journal |
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| Online Access: | http://omjournal.org/articleDetails.aspx?coType=1&aId=2820 |
| _version_ | 1818426923895750656 |
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| author | Khadijah Rizky Sumitro Martono Tri Utomo Agung Dwi Wahyu Widodo |
| author_facet | Khadijah Rizky Sumitro Martono Tri Utomo Agung Dwi Wahyu Widodo |
| author_sort | Khadijah Rizky Sumitro |
| collection | DOAJ |
| description | Objectives: We sought to analyze the neutrophil-to-lymphocyte ratio (NLR) as an alternative marker of neonatal sepsis. Methods: In this cross-sectional study, we undertook consecutive sampling in all inborn neonates admitted to the Neonatal Intensive Care Unit with clinical manifestations of neonatal sepsis. Neonates with congenital anomalies and referred neonates were excluded. Complete blood count, C-reactive protein (CRP), and blood culture were carried out as the septic workup examinations based on the local Clinical Practical Guidelines. NLR is obtained by dividing the absolute count of neutrophils from lymphocytes manually. A cut-off value of NLR is obtained using a receiver operating characteristic curve. Results: The median NLR value of the 104 neonates who met the inclusion and exclusion criteria was 3.63 (2.39–6.12). Neonates with NLR of 2.12 have the area under the curve of 0.630 (95% confidence interval (CI): 0.528–0.741) and 0.725 (95% CI: 0.636–0.814) when combined with CRP = 2.70 mg/dL. Neonates with NLR ≥ 2.12 in clinical neotnatal sepsis had almost double the risk of providing positive blood culture results (relative risk = 1.867, 95% CI: 1.077–3.235; p =0.011). Conclusions: NLR, calculated from complete blood count, can be used as an alternative marker of easy and relatively inexpensive neonatal sepsis, especially in developing countries, and detection of proven neonatal sepsis to be better when combined with CRP. |
| first_indexed | 2024-12-14T14:37:33Z |
| format | Article |
| id | doaj.art-8532829be959465d84b4ce7f6d37973e |
| institution | Directory Open Access Journal |
| issn | 1999-768X 2070-5204 |
| language | English |
| last_indexed | 2024-12-14T14:37:33Z |
| publishDate | 2021-01-01 |
| publisher | Oman Medical Specialty Board |
| record_format | Article |
| series | Oman Medical Journal |
| spelling | doaj.art-8532829be959465d84b4ce7f6d37973e2022-12-21T22:57:32ZengOman Medical Specialty BoardOman Medical Journal1999-768X2070-52042021-01-01361e214e21410.5001/omj.2021.05Neutrophil-to-Lymphocyte Ratio as an Alternative Marker of Neonatal Sepsis in Developing CountriesKhadijah Rizky Sumitro0Martono Tri Utomo1Agung Dwi Wahyu Widodo2Department of Child Health, Faculty of Medicine, Universitas Airlangga- Dr. Soetomo Hospital, Surabaya, IndonesiaDepartment of Child Health, Faculty of Medicine, Universitas Airlangga- Dr. Soetomo Hospital, Surabaya, IndonesiaDepartment of Clinical Microbiology, Faculty of Medicine, Universitas Airlangga- Dr. Soetomo Hospital, Surabaya, IndonesiaObjectives: We sought to analyze the neutrophil-to-lymphocyte ratio (NLR) as an alternative marker of neonatal sepsis. Methods: In this cross-sectional study, we undertook consecutive sampling in all inborn neonates admitted to the Neonatal Intensive Care Unit with clinical manifestations of neonatal sepsis. Neonates with congenital anomalies and referred neonates were excluded. Complete blood count, C-reactive protein (CRP), and blood culture were carried out as the septic workup examinations based on the local Clinical Practical Guidelines. NLR is obtained by dividing the absolute count of neutrophils from lymphocytes manually. A cut-off value of NLR is obtained using a receiver operating characteristic curve. Results: The median NLR value of the 104 neonates who met the inclusion and exclusion criteria was 3.63 (2.39–6.12). Neonates with NLR of 2.12 have the area under the curve of 0.630 (95% confidence interval (CI): 0.528–0.741) and 0.725 (95% CI: 0.636–0.814) when combined with CRP = 2.70 mg/dL. Neonates with NLR ≥ 2.12 in clinical neotnatal sepsis had almost double the risk of providing positive blood culture results (relative risk = 1.867, 95% CI: 1.077–3.235; p =0.011). Conclusions: NLR, calculated from complete blood count, can be used as an alternative marker of easy and relatively inexpensive neonatal sepsis, especially in developing countries, and detection of proven neonatal sepsis to be better when combined with CRP.http://omjournal.org/articleDetails.aspx?coType=1&aId=2820infantnewbornneonatal sepsisneutrophilslymphocytesintensive care unitsneonatalc-reactive protein |
| spellingShingle | Khadijah Rizky Sumitro Martono Tri Utomo Agung Dwi Wahyu Widodo Neutrophil-to-Lymphocyte Ratio as an Alternative Marker of Neonatal Sepsis in Developing Countries Oman Medical Journal infant newborn neonatal sepsis neutrophils lymphocytes intensive care units neonatal c-reactive protein |
| title | Neutrophil-to-Lymphocyte Ratio as an Alternative Marker of Neonatal Sepsis in Developing Countries |
| title_full | Neutrophil-to-Lymphocyte Ratio as an Alternative Marker of Neonatal Sepsis in Developing Countries |
| title_fullStr | Neutrophil-to-Lymphocyte Ratio as an Alternative Marker of Neonatal Sepsis in Developing Countries |
| title_full_unstemmed | Neutrophil-to-Lymphocyte Ratio as an Alternative Marker of Neonatal Sepsis in Developing Countries |
| title_short | Neutrophil-to-Lymphocyte Ratio as an Alternative Marker of Neonatal Sepsis in Developing Countries |
| title_sort | neutrophil to lymphocyte ratio as an alternative marker of neonatal sepsis in developing countries |
| topic | infant newborn neonatal sepsis neutrophils lymphocytes intensive care units neonatal c-reactive protein |
| url | http://omjournal.org/articleDetails.aspx?coType=1&aId=2820 |
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