PLATELET TO LYMPHOCYTE RATIO IN NEONATES: A PREDICTOR OF EARLY ONSET NEONATAL SEPSIS

Introduction Neonatal sepsis (NS) is a common systemic disease that causes morbidity and mortality in newborns. But there is no ideal biomarker that can be used in the early diagnosis of NS. In recent studies, platelet width to lymphocyte ratio (PLR) have been reported to play a critical role in the inflammatory process. In this study, we aimed to contribute to the research about whether or not PLR can be used in the early diagnosis of NS. Methods This retrospective cohort study was conducted among the newborns whose born in İzmir Buca Maternity and Pediatric Hospital between March 2015-February 2016. During these twelve months, 611 neonates with EOS were admitted to our neonatal intensive care unit. One hundred and forty-nine neonates with suspected EOS, 67 neonates with proven EOS and 92 healty neonates were enrolled in the study. Results Platelet width lymphocyte (LPR) values of the groups were calculated 56.5 ± 17.8 vs 62.4± 14.9 vs 15.3 ± 2.1 respectively. PLR values of suspected or proven EOS group was significantly higher than the control group. PLR has AUC 0.89 to 0.93, cutoff value of 39.5 to 57.7, sensitivity of 88.9% to 91.3% and specifity of 94.7% to 97.6%, positive predictive value of 94.3% to 97.4%, and negative predictive value of 88.6% to 91.8% in suspected and proven sepsis diagnosis. Conclusion Based on our results suggest that PLR can be used as a biomarker predictive of EOS.

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Diagnostic Value of Neutrophil to Lymphocyte Ratio and Mean Platelet Volume on Early Onset Neonatal Sepsis on Term Neonate

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1715104 ◽

2020 ◽

Author(s):

Birol Karabulut ◽

Silem Ozdem Alatas

Keyword(s):

Neonatal Sepsis ◽

Predictive Value ◽

Mean Platelet Volume ◽

Early Onset ◽

Area Under The Curve ◽

Neutrophil To Lymphocyte Ratio ◽

Control Group ◽

Platelet Volume ◽

Term Neonates ◽

Lymphocyte Ratio

AbstractBy setting out from increased neutrophil count, decreased lymphocyte count, and increased mean platelet volume (MPV), which is a result of the effect of inflammation on blood cells, we aimed to investigate whether neutrophil to lymphocyte ratio (NLP) and MPV can be used as an auxiliary parameter for the diagnosis of early-onset neonatal sepsis (EOS). This study was conducted by analyzing term neonates with EOS and physiological jaundice who were admitted to the neonatal intensive care unit of Izmir Katip Celebi University Ataturk Training and Research Hospital. A total of 63 neonate files were examined to include 30 term neonates with EOS, and 77 neonate files were examined to include 30 term neonates with physiological jaundice as a control group. NLR had an area under the curve (AUC) of 0.891 for prediction of EOS. At a cut-off level of 1.42, NLR had a likelihood ratio (LR) of 5.5, sensitivity of 88%, a specificity of 84%, a positive predictive value (PPV) of 84.6%, and a negative predictive value (NPV) of 87.5%. MPV had an AUC of 0.666 for the prediction of EOS and at a cut-off level of 9.3 fL, MPV had an LR of 1.23, sensitivity of 84%, a specificity of 32%, a PPV of 55.2%, and an NPV of 66.6%. In conclusion, this study provides evidence that NLR and MPV can be used in addition to conventional parameters in the diagnosis of EOS.

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Diagnostic Markers for Early Detection of Neonatal Sepsis

Journal of Scientific Research in Medical and Biological Sciences ◽

10.47631/jsrmbs.v2i3.319 ◽

2021 ◽

Vol 2 (3) ◽

pp. 13-26

Author(s):

Lara R. Shoukry ◽

Ahmed N. Mohamed ◽

Alzahraa E. A. Sharaf ◽

Osama B. S. Osman

Keyword(s):

Early Diagnosis ◽

Neonatal Sepsis ◽

Predictive Value ◽

Complete Blood Count ◽

Diagnostic Markers ◽

Control Group ◽

Causative Organism ◽

Diagnostic Strategy ◽

Sensitivity Testing ◽

Group I

Background: Neonatal sepsis (NS) is a major health problem throughout the world. The diagnosis of sepsis is challenging due to the non-specific nature of the clinical presentation, the variety of other neonatal disorders with the differential diagnostic workup, lack of sensitivity and specificity of available diagnostic procedures, and the delay in the results of blood cultures in addition to high negative results reported. The diagnosis of suspected sepsis has to be based on clinical symptoms together with biochemical parameters. A diagnostic marker with high diagnostic sensitivity and specificity would be a valuable tool for decreasing the burden of neonatal sepsis Purpose: Evaluate the validity of interleukin-6 (IL-6) in the early diagnosis of neonatal sepsis or the use of a combination of diagnostic markers, C-reactive protein (CRP), and IL-6. Methods: The study included 30 patients with NS (Group I) and 30 healthy newborns as control (Group II) were admitted to Neonatal Intensive Care Unit (NICU) from January 2017 to June 2017. All neonates were subjected to history taking, clinical examination, and laboratory investigations including complete blood count (CBC), blood culture and sensitivity testing, CRP, and IL-6. Results: the most causative organism of neonatal sepsis in NICU was Klebsiella spp. followed by CONS. IL-6 results with cut-off value 50pg/ml, the sensitivity was 100%, the specificity was 90.32%, the positive predictive value of 90.63%, negative predictive value, and the diagnostic accuracy was 95.16. Moreover, IL-6 levels are significantly higher statistically in NS patients than controls. Conclusion: This study validated the diagnostic capability of IL-6 and showed that the combination of CRP and IL-6 as a panel for the early diagnosis of NS could enhance the sensitivity in the diagnosis of NS and may provide a new diagnostic strategy for NS patients Objective: Evaluate the validity of interleukin-6 (IL-6) in early diagnosis of neonatal sepsis or the use of combination of diagnostic markers, C-reactive protein (CRP) and IL-6. Patients and methods: The study included 30 patients with NS (Group I) and 30 apparently healthy newborns as control (Group II) were admitted to Neonatal Intensive Care Unit (NICU) from January 2017 to June 2017. All neonates were subjected to history taking, clinical examination, and laboratory investigations including: complete blood count (CBC), blood culture and sensitivity testing, CRP, and IL-6. Results: the most causative organism of neonatal sepsis in NICU was klebsiella spp. followed by CONS. IL-6 results with cut-off value 50pg/ml, the sensitivity was 100%, the specificity was 90.32%, positive predictive value of 90.63%, negative predictive value, and the diagnostic accuracy was 95.16. Moreover, IL-6 levels are significant higher statistically in NS patients than controls. Conclusion: This study validated the diagnostic capability of IL-6 and showed that the combination of CRP and IL-6 as a panel for the early diagnosis of NS could enhance the sensitivity in the diagnosis of NS and may provide a new diagnostic strategy for NS patients.

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Presepsin - New Marker of Sepsis Romanian Neonatal Intensive Care Unit Experience

Revista de Chimie ◽

10.37358/rc.19.8.7475 ◽

2019 ◽

Vol 70 (8) ◽

pp. 3008-3013

Author(s):

Silvia Maria Stoicescu ◽

Ramona Mohora ◽

Monica Luminos ◽

Madalina Maria Merisescu ◽

Gheorghita Jugulete ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Sepsis ◽

Predictive Value ◽

Neonatal Intensive Care ◽

Complete Blood Count ◽

Clinical Manifestations ◽

Receiver Operating Curve ◽

Predictive Values

Difficulties in establishing the onset of neonatal sepsis has directed the medical research in recent years to the possibility of identifying early biological markers of diagnosis. Overdiagnosing neonatal sepsis leads to a higher rate and duration in the usage of antibiotics in the Neonatal Intensive Care Unit (NICU), which in term leads to a rise in bacterial resistance, antibiotherapy complications, duration of hospitalization and costs.Concomitant analysis of CRP (C Reactive Protein), procalcitonin, complete blood count, presepsin in newborn babies with suspicion of early or late neonatal sepsis. Presepsin sensibility and specificity in diagnosing neonatal sepsis. The study group consists of newborns admitted to Polizu Neonatology Clinic between 15th February- 15th July 2017, with suspected neonatal sepsis. We analyzed: clinical manifestations and biochemical markers values used for diagnosis of sepsis, namely the value of CRP, presepsin and procalcitonin on the onset day of the disease and later, according to evolution. CRP values may be influenced by clinical pathology. Procalcitonin values were mainly influenced by the presence of jaundice. Presepsin is the biochemical marker with the fastest predictive values of positive infection. Presepsin can be a useful tool for early diagnosis of neonatal sepsis and can guide the antibiotic treatment. Presepsin value is significantly higher in neonatal sepsis compared to healthy newborns (939 vs 368 ng/mL, p [ 0.0001); area under receiver operating curve (AUC) for presepsine was 0.931 (95% confidence interval 0.86-1.0). PSP has a greater sensibility and specificity compared to classical sepsis markers, CRP and PCT respectively (AUC 0.931 vs 0.857 vs 0.819, p [ 0.001). The cut off value for presepsin was established at 538 ng/mLwith a sensibility of 79.5% and a specificity of 87.2 %. The positive predictive value (PPV) is 83.8 % and negative predictive value (NPV) is 83.3%.

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Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Tension-Type Headache Patients

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0041-1730124 ◽

2021 ◽

Author(s):

Hasan Hüseyin Özdemir ◽

Ahmet Dönder

Keyword(s):

Systemic Inflammation ◽

Tension Type Headache ◽

Neutrophil To Lymphocyte Ratio ◽

Control Group ◽

C Reactive Protein ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Significant Difference ◽

Type Headache

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.

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Biochemical and immunological markers for the early diagnosis of neonatal septicaemia

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v46i2.49016 ◽

2020 ◽

Vol 46 (2) ◽

pp. 83-89

Author(s):

Ayatun Nesa ◽

Farjana Yesmin ◽

M A Muttalib

Keyword(s):

Tumor Necrosis Factor ◽

Early Diagnosis ◽

Neonatal Sepsis ◽

Predictive Value ◽

Tumor Necrosis ◽

White Cell Count ◽

Sepsis Group ◽

Cross Sectional ◽

Neonatal Septicaemia ◽

Necrosis Factor

Background: Neonatal sepsis is a life-threatening condition with high mortality and morbidity throughout the world. Objective: This study evaluated the diagnostic role of serum procalcitonin (PCT), interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a) and C-reactive protein (CRP) in the early diagnosis of neonatal sepsis. Methods: This cross-sectional study was conducted among neonates admitted to the special baby care unit (SCABU) of BIRDEM General Hospital, Dhaka, from November 2018 to April 2019. According to selection criteria, 90 clinically suspected cases of neonatal sepsis were selected and categorised into confirmed, probable, and no sepsis groups based on CRP, white cell count, platelet count, and blood culture results. Serum PCT, IL-6, and tumor necrosis factor (TNF-a) were estimated in all cases by standard laboratory methods. Results: Serum PCT, IL-6, CRP, and TNF-awere significantly higher in confirmed and probable sepsis groups in comparison to no sepsis group. Among the studied biomarkers, serum PCT was found most sensitive (95% sensitivity), and serum IL-6 was found most specific biomarkers (65.7% specificity) than CRP and TNF-a for the diagnosis of neonatal septicaemia. Though the accuracy of both PCT and IL-6 was found equal (70%), but the positive predictive value (PPV) and negative predictive value (NPV) of serum PCT were higher than IL-6. Conclusion: Both serum PCT and IL-6 are more sensitive and specific markers than CRP and TNF-a in the diagnosis of neonatal sepsis. Moreover, serum PCT is more useful than IL-6. Bangladesh Med Res Counc Bull 2020; 46(2): 83-89

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Role of Serial C-reactive Protein (CRP) in Relation to Total Leucocyte Count, Platelet Count & Blood Culture for early Diagnosis of Neonatal Septicemia in Developing Countries

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v32i2.26032 ◽

2015 ◽

Vol 32 (2) ◽

pp. 61-65

Author(s):

Chiranjib Barua ◽

Md Nurul Anwar ◽

Md Shahidullah ◽

Shahadat Hossain ◽

Sharmila Barua ◽

...

Keyword(s):

Developing Countries ◽

Blood Culture ◽

Early Diagnosis ◽

Neonatal Sepsis ◽

Leucocyte Count ◽

Control Group ◽

Total Leucocyte Count ◽

C Reactive Protein ◽

Neonatal Septicemia ◽

Reactive Protein

Neonatal septicemia is a clinical syndrome of systemic illness accompanied by bacteremia occuring in the first 28 days of life. Neonatal septicemia is one of the major causes of neonatal death in developing countries. Early diagnosis and treatment can prevent neonatal mortality and morbidity. The present study includes: 1) usefulness of CRP (C-reactive protein), Total Leucocyte Count, Platelet Count and Blood Culture in early diagnosis of Neonatal Sepsis, 2) significance of serial CRP in diagnosis of neonatal sepsis. 3) the prognostic value of CRP in neonatal sepsis. This is a prospective study done in neonatal ward, Chittagong Medical College Hospital and carried out from January 2008 to January 2011. Sample size was 300. One hundred fifty neonates with suspected sepsis as cases and 150 healthy babies as control were enrolled in this study. Seventy two percent of cases neonates were preterm and low birth weight. Common risk factors for neonatal septicemia which were identified in this study; preterm (72%), low birth weight (72%), premature rupture membrane (60%), chorioamnionitis (26%) and maternal urinary tract infection (16%) . Out of 150 cases of suspected neonatal sepsis total 80.7%% had raised CRP, in initial sample 70.39% were CRP positive and in 2nd sample additional 9.31% case were CRP positive . In control group 91% were CRP negative. CRP was positive in 100% of culture proven sepsis. Sensitivity of CRP was 80.67% and specificity of CRP was 76.44%. Leucocytosis was observed in 7% of cases and leucopenia was found in 11% of cases. In 82 % cases leucocyte count was found normal. In control group, 95% had normal leucocyte count and 5% had leucocytosis but no leucopenia. Sensitivity of leucocyte count was 18% and specificity was 20.68%. Thrombocytopenia was found in 28% of case group. Out of 150 cases only 15.33% yielded growth of organisms in blood culture. Klebsiella was the most common pathogen isolated which was followed by E.coli and Strph. aureus. Sensitivity of blood culture was 15.33% and specificity was 100% Therefore serial CRP can be taken as alternative method for diagnosis of neonatal sepsis specially in developing countries where blood culture is not readily available.J Bangladesh Coll Phys Surg 2014; 32: 61-65

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The Diagnostic Value of Eosinophil Count And Platelet-To-Lymphocyte Ratio In Eosinophilic Gastroenteritis

10.21203/rs.3.rs-1042591/v1 ◽

2021 ◽

Author(s):

Qiong Lin ◽

Renmin Zhou ◽

Hao Wujuan ◽

Zhumeng Ni ◽

Xiaozhong Li

Keyword(s):

Blood Cell ◽

Roc Curve ◽

Diagnostic Value ◽

Eosinophilic Gastroenteritis ◽

Control Group ◽

Platelet To Lymphocyte Ratio ◽

Roc Curve Analysis ◽

Record System ◽

Lymphocyte Ratio ◽

The Difference

Abstract Objective: To evaluate the diagnostic value of eosinophil (EO) count and platelet-to-lymphocyte ratio (PLR) in eosinophilic gastroenteritis (EGE). Methods: In total, 91 patients with EGE and 83 age–sex matched patients without EGE were selected as study subjects during January 2018 to December 2020. Data on blood cell count, and serum, C-reactive protein (CRP), and albumin levels were obtained from the Wuxi children's hospital electronic medical record system; the neutrophil-to-lymphocyte ratio (NLR), PLR, and CRP-to-albumin ratio (CAR) in the peripheral blood were recorded. Independent sample t-test, non-parametric test, or χ2 test was used according the data type to compare the difference between two groups, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value for EGE. Results: The EO counts and PLR were significantly higher in the EGE group than those in the control group, whereas differences in the white blood cell, lymphocyte, neutrophil, and platelet counts, and the CRP level, NLR, and CAR were not significant. After treatment(Corticosteroids, 1mg/kg.d, lasting for 2 weeks）, the EO counts and PLR in the EGE group decreased gradually and the difference was significant. The diagnostic value of EO counts and PLR was determined with an area under the ROC curve as 0.756 and 0.616, sensitivity was 75.00% and 34.29%, and specificity was 74.29% and 92.31%, respectively. Conclusions EO and PLR represent potential predictive markers for diagnosing EGE.

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Association Between Platelet-to-Lymphocyte Ratio and Preterm Necrotizing Enterocolitis

Frontiers in Pediatrics ◽

10.3389/fped.2021.686880 ◽

2021 ◽

Vol 9 ◽

Author(s):

Juan Zheng ◽

Hua Wang

Keyword(s):

Necrotizing Enterocolitis ◽

Very Low Birth Weight ◽

University Hospital ◽

Preterm Neonates ◽

Control Group ◽

Platelet To Lymphocyte Ratio ◽

Retrospective Case ◽

Low Birth Weight Infants ◽

Intestinal Necrosis ◽

Lymphocyte Ratio

Introduction: Necrotizing enterocolitis (NEC) is a fatal condition for very-low-birth-weight infants. Necrotizing enterocolitis is a multi-factor phenomenon that results in intestinal mucosal damage and leads to intestinal necrosis. However, sensitive laboratory indicators for NEC are lacking, making early diagnosis difficult. This study aimed to explore the relationship between the platelet-to-lymphocyte ratio (PLR) and NEC in preterm neonates to enable an earlier diagnosis of the condition.Methods: This was a retrospective case–control study of preterm neonates diagnosed with NEC between January 2018 and December 2019 in the West China Second University Hospital. Controls were selected from preterm neonatal intensive care unit (NICU) graduates, and they were matched for gestation and year of birth to the preterms diagnosed without NEC. In total, 93 and 107 infants were included in the NEC and control groups, respectively. Empowerstats analysis was used to identify the association between PLR and preterm NEC.Results: The NEC group had significantly higher PLR levels than the control group. PLR > 100 within 1 week before NEC diagnosis was a risk factor for NEC. There was a positive connection between PLR and preterm NEC. A PLR of >100 was determined as the optimal cutoff for predicting preterm NEC, with patients with PLR >100 having a higher risk of NEC [odds ratio (OR): 18.82 (95% confidence interval (CI): 2.93–120.98), p = 0.002].Conclusions: A PLR of >100 within 1 week after clinical abnormalities is associated with a high risk of NEC in preterm neonates.

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The Potential Value of Plasma Receptor Interacting Protein 3 for Neonatal Sepsis Diagnosis

10.21203/rs.3.rs-300543/v1 ◽

2021 ◽

Author(s):

Chuchu Gao ◽

Zongtai Feng ◽

Lixia Wang ◽

Xingxing Zhao ◽

Kai Fu ◽

...

Keyword(s):

Neonatal Sepsis ◽

Diagnostic Value ◽

Sepsis Group ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Interacting Protein ◽

Sepsis Diagnosis ◽

Reactive Protein ◽

Potential Value ◽

Hs Crp

Abstract Background: Neonatal sepsis is a systemic inflammatory response syndrome in neonates. The molecular mechanism of neonatal sepsis remains incompletely clarified. The purpose of this study was to explore the potential value of receptor interacting protein 3 (RIP3) in neonatal sepsis.Methods: 93 neonates with sepsis and 93 neonates without infectious diseases were enrolled in this study from September 2019 to March 2021. Plasma RIP3 was detected by enzyme-linked immunosorbent assay (ELISA) and assessed along with whole blood hypersensitive C-reactive protein (hs-CRP) and platelet count (PLT). Differences of RIP3, hs-CRP and PLT between the two groups were compared. Changes of the three indicators in sepsis were also observed after treatment. The diagnostic value of indicators for neonatal sepsis was evaluated by receiver operating characteristic (ROC) curve.Results: In sepsis group, RIP3 and hs-CRP levels were significantly higher than those in control group (RIP3, p ＜ 0.0001; hs-CRP, p ＜ 0.0001), and PLT level was significantly lower than that in control group (p＜0.0001). After treatment, RIP3 and hs-CRP levels among septic survivors had a significant decrease (p＜0.0001) and PLT level had a significant improvement (p=0.0028). With RIP3＞15464.72 pg/mL, CRP>3.24 mg/L, PLT<205.00×109 /L as the positive criteria, the sensitivity of the three indicators in the diagnosis of neonatal sepsis was 68.8%, 64.5%, 59.1%, and the specificity was 91.4%, 82.8%, 79.6%, respectively. The combination of RIP3, CRP and PLT showed 76.3% sensitivity and 94.6% sensitivity.Conclusions: RIP3 may attribute to the early diagnosis and understanding therapeutic effect of neonatal sepsis. The combined detection of RIP3, CRP and PLT may be more effective than individual ones in the diagnosis of neonatal sepsis.

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