The role of the delta neutrophil index in determining the etiology of neonatal sepsis

Abstract

Abstract Objectives To demonstrate immature granulocyte (IG) count and delta neutrophil index (DNI) values (novel potential predictive marker for neonatal sepsis) for neonates. Methods This prospective controlled clinical study was consisted of 208 patients (77 in the study group and 131 in the control group) who were delivered between January 2016 and January 2018 at the Hacettepe University Neonatal Intensive Care Unit in Ankara, Turkey. In this study, we evaluated value of DNI in diagnosing neonatal sepsis by comparing the DNI values in culture positive septic neonates with healthy neonates. Results In our study, the median interquartile range (IQR = 25–75%) DNI was 0.1% (0.0–0.3%) in the control group and 1.5% (1.0–2.45%) in the sepsis group (p < 0.05). In our ROC curve analysis, the cut-off value for the DNI as a sepsis marker was 0.65%, with 96.2% specificity and 97.4% sensitivity. Those patients with gram-negative isolates had significantly higher DNI and IG counts when compared to those patients with gram-positive bacteria (p < 0.05). Conclusions Our findings indicated that the DNI counts are significant diagnostic biomarkers for neonatal sepsis. They may also have utility in determining the sepsis etiology (differentiating between gram-positive and gram-negative agents).