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Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 16 / No. 2 / Published : 2010-03

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Original Article :

Immature to total neutrophil (i/t) ratio as septic neonatorum diagnostic

Author :

  1. Bastiana*1
  2. Aryati*2
  3. Yulia Iriani*3
  1. Departemen Patologi Klinik, FK UNAIR/RSUD Dr. Soetomo, Surabaya
  2. Departemen Patologi Klinik FK Universitas Airlangga – RSUD Dr. Soetomo Jl. Prof. Mayjen Moestopo 6-8 Surabaya
  3. Bagian Ilmu Kesehatan Anak, FK UNSRI/RSUP Mohamad Hoesin, Palembang

Abstract :

Early diagnosis of neonatal sepsis plays an important role in the management of patients. Blood culture, currently used as the gold standard, has several limitations such as time consuming and low positive rate. For this reason, a rapid and accurate diagnostic method is required. Manual differential count is a practical, inexpensive method and can support the diagnosis of bacterial infections. A shift to the left in differential white count with a raised immature neutrophil count has been documented in patients with bacterial infections. This led to the use of I/T ratio as a indicator towards bacterial infections. The aim of this study is to obtain the diagnostic value of I/T ratio in diagnosing neonatal sepsis. The study was a prospective and cross-sectional. The subjects were enrolled consecutively, consisting of newborn babies (from birth to 30-days old) admitted to the Neonatal Intensive Care Unit (NICU) of the Dr. Soetomo Hospital, Surabaya. Forty and three samples, consisting of 13 sepsis samples and 30 nonsepsis as controls samples were examined. I/T ratio are a ratio between immature neutrophils against total neutrophils in blood smear preparation. For the determination of the white cell differential count, a total of 100 white cells (granulocytes) were counted. I/T ratio > 0.2 showed an abnormality that suggestan infection process occur. Blood smear evaluations were done by three (3) independent observers. The result from three (3) observers were as follows: sensitivity and specificity of I/T ratio in the diagnosis of neonatal sepsis were 69.2%, 92.3%, 61.5% and 50%, 50%, 63.3%, respectively. Positive and negative predictive values were 37.50%, 44.44%, 42.10% and 78.94%, 93.75%, 79.16%, respectively. According to Cochran test there was no difference found between the 3 observers (p = 0.086). However, using Kappa test no agreement between I/T ratio and sepsis (p = 0.051) differences were found. from this study so far, the value in the diagnosis of neonatal sepsis the I/T ratio showed a low diagnostic.

Keyword :

I/T Ratio, neonatal sepsis,

References :

  1. Alistair PGS, (1987). Neonatal infection. Philadhelpia : WB. Saunders Company


Archive Article

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Volume : 16 / No. : 2 / Pub. : 2010-03
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  2. Microbial resistance and sensitivity pattern to antimicrobial drug
  3. Various bacterial cultures related to their susceptibility against several types of antibiotics
  4. Analysis of eosininophil on acute interstitial nephritis
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  6. Immature to total neutrophil (i/t) ratio as septic neonatorum diagnostic
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