Nilai Diagnostik Immature to Total Neutrophil (I/T) Ratio, Immature Granulocyte Count (IG#), dan Immature Granulocyte Percentage (IG%) sebagai Penanda Dini Sepsis Neonatorum

Abstract

ratio, immature granulocyte count (IG#), and immature granulocyte percentage (IG%) as early markers of neonatal sepsis. Method: Analytical study with a cross-sectional design involving 69 neonates with risk factors and clinical symptoms of sepsis treated at Haji Adam Malik Hospital Medan from November 2023 to January 2024. Blood samples were collected in K2-EDTA anticoagulant tubes upon admission. Subsequently, the I/T ratio was manually examined by two blinded examiners, and measurement of IG# and IG% were performed using the Sysmex XN-1000 hematology analyzer. Blood culture results, as secondary data, were obtained from medical records. Results: The majority of subjects (65.2%) were male, and based on onset, 52.2% were late-onset sepsis. The positivity rate of blood cultures was 32%, with 77.3% of them caused by gram-negative bacteria. The median I/T ratio, IG#, and IG% were 0.14, 0.22 x 103/μL, and 1.8%, respectively. I/T ratio at a cut-off of 0.20, IG# at a cut-off of 0.29 x 103/μL, and IG% at a cut-off of 1.9% had sensitivities and specificities of 81.8% and 78.7%, 68.2% and 68.1%, 72.7% and 68.1%, respectively, as early markers of neonatal sepsis. The risk of sepsis increased by 13.35 times in neonates with I/T ratio ≥ 0.20 and 3.86 times in neonates with IG% ≥ 1.95%. Conclusion: IG# and IG% have diagnostic values comparable to I/T ratio, thus can also be used for early diagnosis of neonatal sepsis.