Neutrophil to lymphocyte ratio as a marker of neonatal sepsis in resource limited settings

Abstract

Background: Neonatal period forms basic foundation which influences the future health of a child. It is often complicated by neonatal sepsis. In resource limited settings especially in rural and tribal areas with limited laboratory services it will be not possible to have all investigations. Study aims to determine utility of simple neutrophil to lymphocyte ratio as a marker of sepsis in neonates within the first week of life.Methods: Retrospective descriptive study in a tertiary care hospital in Kochi. Objective of this study was to analyse neutrophil to lymphocyte ratio in babies with sepsis to that of babies without sepsis. Data of 300 babies were collected which included 150 babies with sepsis and 150 babies with no sepsis. Records showing complete history, clinical diagnosis, appropriate investigation and management details of term babies within 7 days of life were included. Preterm babies, Babies with congenital malformations, outborn babies, babies with incomplete records were excluded.Results: In this study, mean value of neutrophil to lymphocyte ratio in babies with sepsis were 3.73 compared to 1.22 in babies with no sepsis. For babies with sepsis±1SD values were 5.21 and 2.25 respectively and for babies with no sepsis were 1.74 and 0.70. For babies with sepsis±2 SD values 0.77 and 6.69 respectively and 0.18 and 2.26 for babies with no sepsis.Conclusions: Mean values of NLR values were significantly higher in those with sepsis than in those without sepsis NLR ratio is higher in cases with sepsis (3.728±1.483) compared to the cases with no sepsis (1.217±0.521). A value more than 2.25 can be indicator of sepsis.