Diagnostic value of mean platelet volume in neonatal sepsis

Kristopher May Pamudji; I Made Kardana

doi:10.14238/pi59.6.2019.289-93

Kristopher May Pamudji Medical School Udayana University
I Made Kardana Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali

DOI: https://doi.org/10.14238/pi59.6.2019.289-93

Keywords: mean platelet volume; neonatal sepsis; sensitivity; specificity

Abstract

Background Neonatal sepsis is a severe disease with potentially serious impacts if not treated early. However, the symptoms and clinical signs are not specific. Several studies have been conducted to find early infection markers for detection of neonatal sepsis, but without satisfactory results. Mean platelet volume (MPV) is a new marker of infection that has good potential for diagnosing neonatal sepsis.

Objective To assess the diagnostic value of MPV in early detection of neonatal sepsis.

Methods This retrospective study with diagnostic testing was done with data collected from medical records of neonates with neonatal sepsis who were admitted to the Neonatology Department in Sanglah Hospital, Denpasar from December 2018 to March 2019. Mean platelet volume cut-off point was determined using a receiver-operating characteristic (ROC) curve. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MPV in neonatal sepsis were determined using a 2x2 table.

Results Of 82 subjects, 55 subjects were male (67%). Positive blood culture results were found in 25 subjects (30%). Mean platelet volume with a cut-off point of 7.44 fL had 80% sensitivity, 84.2% specificity, 69% PPV, and 90.6% NPV.

Conclusion Mean platelet volume with a cut-off point of 7.44 fL can be used to diagnose neonatal sepsis with a sensitivity of 80% and specificity of 84.2%.

References

1. Shah BA, Padbury JF. Neonatal sepsis: an old problem with new insights. Virulence. 2014;5:170-8.
2. Coetzee M, Mbowane NT, de Witt TW. Neonatal sepsis: highlighting the principles of diagnosis and management. S Afr J Child Health. 2017;11:99-103.
3. Shaha CK, Dey SK, Shabuj KH, Chisti J, Mannan MA, Jashimuddin, et al. Neonatal sepsis- A review. Bangladesh J Child Health. 2012;36:82-9.
4. Aminullah A. Sepsis pada bayi baru lahir. In: Kosim MS, Yunanto A, Dewi R, Sarosa GI, Usman A, editors. Buku ajar neonatologi. 1st ed. Jakarta: Badan Penerbit IDAI; 2010. p. 170-87.
5. Putra PJ. Insiden dan faktor-faktor yang berhubungan dengan sepsis neonatus di RSUP Sanglah Denpasar. Sari Pediatri. 2012;14:205-10.
6. Shane AL, Sanchez PJ, Stoll BJ. Neonatal sepsis. Lancet. 2017;390:1770-80.
7. Iroh Tam PY, Bendel CM. Diagnostics for neonatal sepsis: current approaches and future directions. Pediatr Res. 2017;82:574-83.
8. Senturk M, Azgin I, Ovet G, Alatas N, Agirgol B, Yilmaz E. The role of the mean platelet volume and neutrophil-to-lymphocyte ratio in peritonsillar abscesses. Braz J Otorhinolaryngol. 2016;82:662-7.
9. Khoshdel A, Mahmoudzadeh M, Kheiri S, Imani R, Shahabi G, Saedi E, et al. Sensitivity and specificity of procalcitonin in diagnosis of neonatal sepsis. Iran J Pathol. 2008;3:203-7.
10. El-Din EM, El-Sokkary MM, Bassiouny MR, Hassan R. Epidemiology of neonatal sepsis and implicated pathogens: a study from Egypt. Biomed Res Int. 2015;2015:1-11.
11. Juniatiningsih A, Aminullah A, Firmansyah A. Profil mikroorganisme penyebab sepsis neonatorum di Departemen Ilmu Kesehatan Anak Rumah Sakit Cipto Mangunkusumo Jakarta. Sari Pediatri. 2008;10:60-5.
12. Bhat YR. Platelet indices in neonatal sepsis: a review. World J Clin Infect Dis. 2017;7:6-10.
13. Korniluk A, Koper-Lenkiewicz OM, Kaminska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm. 2019;2019:9213074.
14. Tajarernmuang P, Phrommintikul A, Limsukon A, Pothirat C, Chittawatanarat K. The role of mean platelet volume as a predictor of mortality in critically ill patients: a systematic review and meta-analysis. Crit Care Res Pract. 2016;2016:4370834.
15. Orak M, Karakoc Y, Ustundag M, Yildirim Y, Celen MK, Guloglu C. An investigation of the effects of the mean platelet volume, platelet distribution width, platelet/lymphocyte ratio, and platelet counts on mortality in patients with sepsis who applied to the emergency department. Niger J Clin Pract. 2018;21:667-71.
16. El Rahman HM, Mahmoud SF, Ezzat AW, Roshdy AE. Mean platelet volume versus total leukocyte count and C-reactive protein as an indicator for mortality in sepsis. Egypt J Hosp Med. 2018;71:2373-9.
17. Dursun A, Ozsoylu S, Akyildiz BN. Neutrophil-to-lymphocyte ratio and mean platelet volume can be useful markers to predict sepsis in children. Pak J Med Sci. 2018;34:918-22.