Serum and Urine C - Reactive Protein, Mean Platelet Volume and Neutrophil/ Lymphocyte Ratio as Diagnostic Values in Neonatal Sepsis

Recently, many research studies with equivocal results, have found Neonatal Sepsis (NS) biomarkers and focused on single regions. Therefore, the aim of this study was to evaluate serum and urine C - Reactive Protein (CRP), Mean Platelet Volume (MPV) and Neutrophil/ Lymphocyte Ratio (NLR) as diagnostic values in NS.

This case-control study was performed on 147 cases (79 overweight or obese children and 68 normal weight children). For evaluating quality of life, the original version of the PedsQL, quality of life questionnaire, was used.

This descriptive-analytical research analyzed Shahid Beheshti Hospital’s probable NS patients. All individuals got a complete blood count, white blood differential, CRP, blood culture, and urine culture. Data was analyzed by SPSS v24.

The data indicated that NS infants had substantially higher mean serum levels of MPV (10.63 ± 1.03 vs. 8.63 ± 0.96, P<0.001), NLR (2.08 ± 1.24 vs. 1.01 ± 0.5, P<0.001), and CRP (12.97 ± 5.09 vs 5.83 ± 2.6 and 9.61 ± 3.25 vs 4.9 ± 3.4, P<0.001).The optimum cut-off points for serum and urine CRP, NLR, and MVP were 10, 6.7, 1.2, and 9.5. The highest Area under the Curve (AUC) was detected in MPV (0.909), and the other AUC for serum and urine CRP and NLR were 0.872, 0.831, and 0.804, respectively. Serum CRP had the lowest sensitivity (73.3%) among urine, NLR, and MPV. Serum CRP had the best specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV), identified as 96.7 %, 88%, and 90%, respectively.

Sepsis increases MPV, serum and urine CRP, and NLR in neonates. MPV and serum CRP may detect NS early.