The following is a summary of “Meta-analysis of the role of neutrophil to lymphocyte ratio in neonatal sepsis,” published in the November 2023 issue of Infectious Disease by Chen et al.

The neutrophil-to-lymphocyte ratio (NLR) is a readily available inflammatory biomarker that reflects the balance between innate and adaptive immune responses.

Researchers performed a retrospective study to assess the diagnostic utility of the NLR in neonates with suspected sepsis. They systematically searched for relevant publications published before May 14, 2022, using PubMed, Web of Science, and Scopus.

The results showed 30 studies with 2,328 neonates diagnosed with sepsis and 1800 neonates in the control group. NLR was found to be higher in neonates with sepsis compared to healthy controls (SMD = 1.81, 95% CI = 1.14–2.48, P<0.001), in both prospective (SMD = 2.38, 95% CI = 1.40–3.35, P<0.001) and retrospective studies (SMD = 0.87, 95% CI = 0.63–1.12, P<0.001), with a pooled sensitivity of 79% (95% CI = 62–90%) and a pooled specificity of 91% (95% CI = 73–97%). Elevated NLR in neonatal sepsis versus suspected cases with negative blood cultures (SMD = 1.99, 95% CI = 0.76–3.22, P=0.002), with 0.79% sensitivity (95% CI = 0.69–0.86%) and 73% specificity (95% CI = 54–85%). Neonates with sepsis had higher NLR than other ICU-admitted neonates (SMD = 0.73, 95% CI = 0.63–0.84, P<0.001), with 0.65 sensitivity (95% CI, 0.55–0.80) and 0.80 specificity (95% CI, 0.68–0.88).

Investigators concluded that NLR emerged as a promising biomarker for neonatal sepsis. It may inform interventions restoring the balance between innate and adaptive immunity.

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-023-08800-0