Iranian journal of Pediatric Hematology and Oncology

en Utilizing Neutrophil Extended Parameters for the Screening of Early-Onset Neonatal Sepsis هماتولوژی Hematology پژوهشي Research <div style="border: 1.5pt double windowtext; padding: 1pt 4pt; text-align: justify;">Background: Early-onset neonatal sepsis (EOS), occurring within the first 72 hours of life, is a significant cause of morbidity and mortality in newborns. Prompt diagnosis remains a challenge due to the nonspecific nature of clinical signs and the delayed results from standard diagnostic methods such as blood culture. Traditional hematological markers, including total neutrophil count and the immature-to-total neutrophil (I: T) ratio, have shown limited sensitivity and specificity in the early detection of EOS. This study investigates the diagnostic utility of both conventional and novel neutrophil indices, such as absolute neutrophil count (ANC), immature granulocyte (IG) count, I: T ratio, and the advanced scatter-based parameters Neut-Y (neutrophil reactivity index) and Neut-X (neutrophil granularity index), using automated hematology analyzers to improve the early identification of EOS. Materials and Methods: This prospective study analyzed clinical data from 135 presumed sepsis neonates identified as having maternal and fetal risk factors for early-onset neonatal sepsis. Blood investigations, including full blood counts, differential counts using the Sysmex XE-series (Sysmex Corporation, Kobe, Japan), and blood cultures, were performed. Biochemical markers and neutrophil parameters were analyzed to distinguish sepsis cases from non-sepsis cases. Results: ANC and neut-Y (neut-RI) were found to be significant biomarkers for early-onset neonatal sepsis (p < 0.05). These two parameters can be used to differentiate between sepsis and non-sepsis, with a cut-off value of ANC and neut-Y (neut-RI) as 8.46 x 103/ul and 33.85ch, respectively. Conclusion: ANC and neut-Y are promising tools for screening early-onset neonatal sepsis. The clinical history of risk factors supplemented with these two parameters will help to identify neonates who are at risk of sepsis and assist in further and prompt management.</div> Bacterial Infections and Mycoses, Infant, Newborn, Neutrophil Activation, Sepsis 661 672 http://ijpho.ssu.ac.ir/browse.php?a_code=A-10-1198-1&slc_lang=en&sid=1 Nik Noor Fadhi Nik Mansor Nik Noor Fadhi Nik Mansor nick14dlah89@yahoo.com 0000-0002-2986-8204 No Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Sarah Abdul Halim Sarah Abdul Halim sarahabdulhalim@iium.edu.my 0000-0003-4276-5207 No Department of Pathology and Laboratory Medicine, Kulliyah of Medicine, International Islamic University Malaysia Department of Pathology and Laboratory Medicine, Kulliyah of Medicine, International Islamic University Malaysia Rosline Hassan Rosline Hassan roslin@usm.my 0000-0003-0493-1390 Yes Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia . Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Razan Hayati Zulkeflee Razan Hayati Zulkeflee rhayatiz@usm.my 0000-0003-2760-07 No Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Nor Rosidah Ibrahim Nor Rosidah Ibrahim rosirosi@usm.my 0000-0002-9576-8017 No Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Wan Rosilawati miro Rasheeq Wan Rosli Wan Rosilawati Wan Rosli 0000-0002-4195-1051 No Department of Obstetrics and Gynaecology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Department of Obstetrics and Gynaecology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Sumaiyah Adzahar Sumaiyah Adzahar sumaiyahadzahar@unisza.edu.my 0000-0003-3378-1897 No Department of Pathology and Medical Laboratory, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia Department of Pathology and Medical Laboratory, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia Muhammad Amiro Rasheeq Mohd Radzi Muhammad Amiro Rasheeq Mohd Radzi mar@usm.my 0000-0001-5066-2908 No Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia Nur Ilyia Syazwani Saidin Nur Ilyia Syazw Saidin nurilyia@usm.my 0000-0002-0578-0793 No . Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia . Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia