Abstract
Abstract Objectives To demonstrate immature granulocyte (IG) count and delta neutrophil index (DNI) values (novel potential predictive marker for neonatal sepsis) for neonates. Methods This prospective controlled clinical study was consisted of 208 patients (77 in the study group and 131 in the control group) who were delivered between January 2016 and January 2018 at the Hacettepe University Neonatal Intensive Care Unit in Ankara, Turkey. In this study, we evaluated value of DNI in diagnosing neonatal sepsis by comparing the DNI values in culture positive septic neonates with healthy neonates. Results In our study, the median interquartile range (IQR = 25–75%) DNI was 0.1% (0.0–0.3%) in the control group and 1.5% (1.0–2.45%) in the sepsis group (p < 0.05). In our ROC curve analysis, the cut-off value for the DNI as a sepsis marker was 0.65%, with 96.2% specificity and 97.4% sensitivity. Those patients with gram-negative isolates had significantly higher DNI and IG counts when compared to those patients with gram-positive bacteria (p < 0.05). Conclusions Our findings indicated that the DNI counts are significant diagnostic biomarkers for neonatal sepsis. They may also have utility in determining the sepsis etiology (differentiating between gram-positive and gram-negative agents).
Highlights
Neonatal sepsis is one of the major causes of mortality and morbidity in newborns [1, 2] and, the incidence of confirmed sepsis in developing countries is 16 per 1,000 live births [3]
Our findings indicated that the delta neutrophil index (DNI) counts are significant diagnostic biomarkers for neonatal sepsis
It has been proposed that the immature granulocyte (IG) ratio automatically obtained from complete blood count devices can be used as a new sepsis biomarker
Summary
Neonatal sepsis is one of the major causes of mortality and morbidity in newborns [1, 2] and, the incidence of confirmed sepsis in developing countries is 16 per 1,000 live births [3]. Due to the physiological features of neonates and the limitations in the laboratory techniques, blood cultures require 48–72 h to detect bacterial growth, and they may even yield false negative results. Biomarkers can be used to obtain rapid results supporting a sepsis diagnosis, with new biomarkers constantly in development [5]. The most commonly used biomarkers are the C-reactive protein (CRP) level, procalcitonin level, total leukocyte count, and immature to total (I/T) neutrophil ratio [6, 7]. It has been proposed that the immature granulocyte (IG) ratio automatically obtained from complete blood count devices (delta neutrophil index, DNI) can be used as a new sepsis biomarker
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