Usefulness of the delta neutrophil index for assessing neonatal sepsis

Abstract

Aim: We investigated the significance of the calculated delta neutrophil index (DNI) as a diagnostic factor for neonatal sepsis.

Methods: In retrospective study, 24 infants were diagnosed with blood culture-proven sepsis, and 48 non-septic neonates matched for gestational age, and birth weight served as controls. Among the 24 infants with sepsis, 5 died within 7 days at diagnosis.

Results: Mean DNI (at diagnosis, after 24 h and 72 h), CRP and WBC counts were significantly higher, and neutrophil and platelet counts were significantly lower in sepsis group than control group. In sepsis group, mean DNI at the time of diagnosis, DNI at 72 h, and CRP at 72 h were significantly higher, and platelet counts were significantly lower for patients with sepsis who died compared with those who survived. In multiple logistic regression analysis, mortality in neonates with sepsis significantly correlated with DNI at 72 h (OR 1.47, 95% CI 1.1-5.6, p = 0.032) and with platelet count (OR 0.93, 95% CI 0.51-0.99, p = 0.014). ROC analysis for DNI at 72 h revealed a cut-off value of 12%, which predicted mortality with 81% sensitivity and 87% specificity.

Conclusion: DNI may be a valuable tool in assessing the prognosis of patients with neonatal sepsis.