Abstract Ref Number = APCP1003
NEUTROPHIL-LYMPHOCYTE COUNT RATIO COMPARED TO PROCALCITONIN IN DETECTING BACTEREMIA ON LATE ONSET NEONATAL SEPSIS
Masayu Lubna,Dwi Hidayah,Yulidar Hafidz
Pediatric department Medical faculty of Sebelas Maret University Neonatology subdivision Pediatric department Medical faculty of Sebelas Maret University Neonatology subdivision Pediatric department Medical faculty of Sebelas Maret University
Background : Incorrect or delayed diagnosis of bacteremia or sepsis increases morbidity and mortality in neonates. Serum procalcitonin has a high accuracy for recognizing neonates with late-onset sepsis (>72 hours of life). Neutrophil-lymphocyte count ratio has showed simple promising method to evaluate systemic inflammation in neonatal sepsis. Thus, we conducted this study to compare NLCR to PCT in detecting bacteremia on late-onset neonatal sepsis.
Material : This retrospective study included 53 patients with late-onset sepsis admitted to Moewardi Hospital from January to December 2017. The cutoff values of PCT level and NLCR were 2 ng/ml and ? 5, respectively. The dummy table was used to evaluate the sensitivity and specificity of these parameters. The unpaired T-test was used to assess the comparability of NLCR to PCT in predicting bacteremia with ?=0.05.
Results : Of the total patients, 26 (49%) were proven late-onset neonatal sepsis from blood culture. Gram negative bacteria was mostly causative pathogen. Maternal infection, gestational age and birth weight were significant risk factors. Sensitivity, specificity, positive predictive value, negative predictive value of PCT were 84.6%, 40.7%, 0.57, and 0.73 respectively. NLCR had sensitivity of 15.4%, specificity of 89%, positive predictive value of 0.57 and negative predictive value of 0.52. NLCR and PCT were not significantly different in detecting bacteremia on late-onset neonatal sepsis (p>0.05).
Conclusions : Both NLCR and PCT may help to determine bacteremia and or sepsis in neonates. Although NLCR has higher specificity than that of PCT, it has lower sensitivity compared to PCT. Thus PCT is more reliable in detecting bacteremia and NLCR can be used as a complement parameter to define neonatal sepsis.
Keywords: neutrophil-lymphocyte count ratio procalcitonin bacteremia late onset neonatal sepsis