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By setting out from increased neutrophil count, decreased lymphocyte count, and increased mean platelet volume (MPV), which is a result of the effect of inflammation on blood cells, we aimed to investigate whether neutrophil to lymphocyte ratio (NLP) and MPV can be used as an auxiliary parameter for the diagnosis of early-onset neonatal sepsis (EOS). This study was conducted by analyzing term neonates with EOS and physiological jaundice who were admitted to the neonatal intensive care unit of Izmir Katip Celebi University Ataturk Training and Research Hospital. A total of 63 neonate files were examined to include 30 term neonates with EOS, and 77 neonate files were examined to include 30 term neonates with physiological jaundice as a control group. NLR had an area under the curve (AUC) of 0.891 for prediction of EOS. At a cut-off level of 1.42, NLR had a likelihood ratio (LR) of 5.5, sensitivity of 88%, a specificity of 84%, a positive predictive value (PPV) of 84.6%, and a negative predictive value (NPV) of 87.5%. MPV had an AUC of 0.666 for the prediction of EOS and at a cut-off level of 9.3 fL, MPV had an LR of 1.23, sensitivity of 84%, a specificity of 32%, a PPV of 55.2%, and an NPV of 66.6%. In conclusion, this study provides evidence that NLR and MPV can be used in addition to conventional parameters in the diagnosis of EOS.

Introduction Neonatal sepsis (NS) is a common systemic disease that causes morbidity and mortality in newborns. But there is no ideal biomarker that can be used in the early diagnosis of NS. In recent studies, platelet width to lymphocyte ratio (PLR)  have been reported to play a critical role in the inflammatory process. In this study, we aimed to contribute to the research about whether or not PLR can be used in the early diagnosis of NS. Methods This retrospective cohort study was conducted among the newborns whose born in İzmir Buca Maternity and Pediatric Hospital between March 2015-February 2016. During these twelve months, 611 neonates with EOS were admitted to our neonatal intensive care unit. One hundred and forty-nine neonates with  suspected EOS, 67 neonates with proven EOS and 92 healty neonates were enrolled in the study. Results Platelet width lymphocyte (LPR) values of the groups were calculated 56.5 ± 17.8 vs 62.4± 14.9 vs 15.3 ± 2.1 respectively. PLR values of suspected or proven EOS group was significantly higher than the control group. PLR has AUC 0.89 to 0.93, cutoff value of 39.5 to 57.7, sensitivity of 88.9% to 91.3% and specifity of 94.7% to 97.6%, positive predictive value of 94.3% to 97.4%, and negative predictive value of 88.6% to 91.8% in suspected and proven sepsis diagnosis. Conclusion Based on our results suggest that PLR can be used as a biomarker predictive of EOS.

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