A comparison of neutrophil gelatinase-associated lipocalin and immature to total neutrophil ratio for diagnosing early-onset neonatal sepsis
Abstract: Neonatal sepsis is a
clinical syndrome caused by the invasion of microorganisms into the
bloodstream. Early diagnosis of early-onset neonatal sepsis (EONS) is
difficult. Laboratory tests with high sensitivity and specificity are needed in
order to make early diagnoses in newborns.
Objective To compare the sensitivity and specificity of neutrophil
gelatinase-associated lipocalin (NGAL) and immature to total (IT) neutrophil
ratio for the diagnosis of early-onset neonatal sepsis.
Methods This observational study with cross-sectional design was
conducted in the Neonatology Division, Prof. R. D. Kandou General Hospital from
November 2012 to April 2014. Consecutive sampling was applied. There were 103
newborns with suspected EONS who fulfilled the inclusion criteria. Complete
blood counts, blood cultures, as well as NGAL and IT ratio measurements were
performed.
Results NGAL was not significantly more sensitive than IT ratio [80.4%
vs. 67.3%, respectively; (P=0.058)]. However, NGAL had lower specificity than
IT ratio (27.7% vs. 50.0%, respectively; P=0.016). The positive predictive
values (57.0% vs. 64.9%, respectively; P=0.176), and negative predictive values
(54.2% vs. 52.6%, respectively; P=0.451) were similar in both diagnostic tests.
Conclusion Immature to total neutrophil (IT) ratio has higher specificity
compared to NGAL for early diagnosis of EONS. However, the difference in
sensitivity between the two test is not statistically significant.
Author: Rocky Wilar, Dasril
Daud, Suryani As’ad, Dwi Bahagia Febriani, Mina
Journal Code: jpkedokterangg160036
