Vita Pramatasari Harti, Andhika Trisna Putra, Dwi Hidayah DE ace ana ae nee en ACA CCCI eee Ce a aecy OBJECTIVE Neonatal sepsis is a major cause of neonatal morbidity and mortality, especially in developing countries. Blood culture as the gold standard is expensive and time consuming. Therefore, various biomarkers are used for early detection of neonatal sepsis. The aim of this study was to evaluate the diagnostic efficiency of red cell distribution width (RDW) and neutrophil- lymphocyte ratio (NLR) as predictors of neonatal sepsis. METHOD This is a retrospective observational study. Neonates with sepsis treated at the Neonatology Unit of Moewardi Hospital of Surakarta during October 2020 - March 2021. They were selected by consecutive sampling. Analysis was performed by IBM SPSS Statistics 19 with P value <0.05 was considered as significant. iaiUihy This study included 149 neonates with neonatal sepsis who fulfilled the criteria. There were 48 neonates (32.2%) with positive blood culture and 101 neonates (67.7%) with negative blood culture. Mean RDW values was 13.5 in the positive culture group and 11.4 in the negative culture group. Mean NLR value was 3.07 in the positive culture group and 2.34 in the negative culture group. The RDW and NLR values between the two groups were not different significantly. RDW with cut off >4.53% has a sensitivity value of 81% and a specificity of 80%, AUC 0.424. NLR with cut off >1.595 had a sensitivity value of 64% and a specificity of 57%, AUC 0.561. The combination of RDW and NLR had a significant correlation with positive blood culture results with P value <0.05 (r= 0.27; p= 0.041). In this study, ROW and NLR cannot be used as predictors of neonatal sepsis. The combination of these two parameters showed a significant correlation with positive blood culture results. q Table 1. Baseline characteristics of the subjects nO nog nO) Wale zo) s1{60a)seis6) ase Fema 25(5211 096) SIA36) ‘senator es roy 300 apr) sor) ose Pretern soles) alana) S362) seth ween Vorvlow Binh wight 31228) 38(385) a7(ais) 008 low th Wee mw ats) eaten) Nomalbithweghe 371358) 231228) S026) Mode Delvery ‘Spontaneous zaisss) 591584) 870554) 86 Seco Conarea| mown | yas) erlang) tos 2658 75712) soi(ers) oom tos miss) 26058) aa(322), Figure 1. Comparison of RDW and NLR levels to blood culture results ROW NLR i Positive Blood Culture Negative Blood Culture Table 2. Performance of biochemical markers in distinguishing between cases with positive blood culture and cases with negative blood culture ‘cutoff Youden Parameter/Marker AUC Senatty.Specfity ‘value ‘index ROW (%) 453 06130424 © 809% BAK Nun 1595 02070561 638K 56.9% REFERENCES 1. Mousa SO, Moustafa AN, Aly HM. Prognostic value of red cell distribution width, platelet parameters, and the hematological scoring system in neonatal sepsis. Egypt J Haematol. 2019;44:183-9 2. Sumitro KR, Utomo MT, Widodo ADW. Neutrophil-to- lymphocyte ratio as an alternative marker of neonatal sepsis in developing countries. Oman Med J 2021;36:514-9 3. Zhang HB, Chen J, Lan QF, Ma XJ, Zhang SY. Diagnosti values of red cell distribution width, platelet distribution width and neutrophil-lymphocyte count ratio for sepsis. Exp Ther Med. 2016;12:2215-9