Hasibuan Beby S, Dasatjipta Guslihan, Lubis Bugis M, Sanny Sanny
Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Narra J. 2024 Aug;4(2):e763. doi: 10.52225/narra.v4i2.763. Epub 2024 May 31.
Clinical manifestations of neonatal sepsis are often unspecified. Therefore, sepsis biomarkers could be used to support diagnosis while waiting for blood culture results, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). The aim of this study was to evaluate the role of NLR and PLR as diagnostic markers in neonatal sepsis. A cross-sectional study was conducted at Haji Adam Malik General Hospital, Medan, Indonesia, from April to October 2019. This study included neonates aged less than 28 days, diagnosed with suspected sepsis, and had no previous history of antibiotics administration. Patients underwent clinical assessment, laboratory examination, and blood culture. Patients were grouped into sepsis and non-sepsis based on the blood culture results. The median hematological examination and the range of NLR and PLR in both the sepsis and non-sepsis groups were subjected to analysis using the Mann-Whitney U test to assess differences. NLR and PLR optimal cut-off values were determined using a receiver operator curve (ROC) with a confidence interval of 95%. A total of 137 neonates were enrolled, of which 49 were classified as sepsis and 89 as non-sepsis based on blood culture results. The optimal cutoff values for NLR and PLR were 2.75 and 11.73. Using those cutoff values, NLR and PLR could predict neonatal sepsis with sensitivities of 52.1% and 47.9%, specificities of 50.6% and 47.2%, area under the curve (AUC) of 0.46 and 0.47, with =0.525 and =0.662, respectively. Further investigation is warranted to refine the NLR and PLR utility and enhance diagnostic accuracy in clinical practices.
新生儿败血症的临床表现往往不明确。因此，在等待血培养结果时，败血症生物标志物可用于辅助诊断，如中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）。本研究的目的是评估NLR和PLR作为新生儿败血症诊断标志物的作用。2019年4月至10月在印度尼西亚棉兰的哈贾·亚当·马利克综合医院进行了一项横断面研究。本研究纳入了年龄小于28天、被诊断为疑似败血症且既往无抗生素使用史的新生儿。患者接受了临床评估、实验室检查和血培养。根据血培养结果将患者分为败血症组和非败血症组。使用Mann-Whitney U检验对败血症组和非败血症组的中位血液学检查以及NLR和PLR范围进行分析，以评估差异。使用置信区间为95%的受试者工作特征曲线（ROC）确定NLR和PLR的最佳截断值。共纳入137例新生儿，根据血培养结果，其中49例被分类为败血症，89例为非败血症。NLR和PLR的最佳截断值分别为2.75和11.73。使用这些截断值，NLR和PLR预测新生儿败血症的敏感性分别为52.1%和47.9%，特异性分别为50.6%和47.2%，曲线下面积（AUC）分别为0.46和0.47，P值分别为0.525和0.662。有必要进行进一步研究，以完善NLR和PLR的效用，并提高临床实践中的诊断准确性。
