Validity of eosinophil count and monocyte-lymphocyte ratio for early detection of neonatal sepsis

Background: Sepsis is a major cause of mortality in neonatal. Diagnosing neonatal sepsis is a challenge, as its clinical symptoms are not specific. Various studies have been conducted to identify infection markers for early identification of neonatal sepsis, but none have shown satisfactory results. Therefore, we aimed to determine the validity of eosinophil count and monocyte lymphocyte ratio (MLR) for the early detection of neonatal sepsis.

Objective: To determine the validity of eosinophil count and monocyte lymphocyte ratio (MLR) for the early detection of neonatal sepsis.

Methods: This study was a retrospective study with a diagnostic test. Data were collected from medical records of neonates with early-onset neonatal sepsis (EONS) or clinically EONS who were admitted to Neonatal Ward in Sanglah Hospital between April 2020 and December 2020. The ROC curve was used to determine the cut-off point of eosinophil count and MLR. Furthermore, a chi-squared test was used to determine sensitivity, specificity, PPV, and NPV

Results: The total sample was 100 subjects, and 28 subjects had positive blood culture (28%). The eosinophil count (cut-off of 0.16x103/µL or 160 cell/mm3) produced a sensitivity of 57.14%, specificity of 65.28%, PPV of 39.02%, and NPV of 79.66%. At a cut-off value of 0.38, MLR had a sensitivity of 67.86%, specificity of 72.22%, PPV of 48.72%, and NPV of 85.25%.

Conclusion: Monocyte-lymphocyte ratio has good specifity and NPV for early detection of neonatal sepsis, whereas the eosinophil count is less sensitive and specific.