Background and Objective: Neonatal sepsis is associated with high mortality and has a favourable outcome when recognized and treated in a timely manner. In resource-limited settings, there is need for an affordable test with a short turnaround time for timely diagnosis of sepsis. The study was aimed to find out the role of eosinopenia and neutrophil-to-lymphocyte ratio (NLR) in screening for early-onset sepsis (EOS) and to determine the cut-off point for absolute eosinophil count (AEC) and NLR to predict early-onset neonatal sepsis.
Methods: This descriptive study was conducted on neonates with suspected EOS at Medical College Hospital, Chennai, Tamil Nadu, India. Complete blood count, C-reactive protein, blood culture, and antibacterial sensitivity were assessed, and neonates with laboratory evidence of sepsis were considered as EOS group. AEC and NLR were compared between groups. Specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Receiver operating characteristic (ROC) analysis was performed. The median value of AEC and NLR was compared with the Mann -Whitney test.
Findings: Among the 140 neonates studied, 72(51.4%) had low birth weight. The absolute neutrophil count was higher (8954 vs. 7322) and the absolute lymphocyte count (3040 vs. 5593) and platelet count were lower in sepsis (126074 vs. 239151). Eosinopenia with cut-off point of 194.5 and NLR with a cut-off point of 1.565 had higher sensitivity than specificity and a high negative predictive value (NPV).
Conclusion: It can be concluded that eosinopenia and NLR are useful tools in the diagnosis of early -onset sepsis.