Nucleated Red Blood Cells and Serum Lactate for the Diagnosis of Neonatal Sepsis

This study aimed to assess the diagnostic accuracy of nucleated red blood cells (NRBCs) and lactate levels in the severity of neonatal sepsis. A cross-sectional analytical study was conducted at the Department of Haematology, Combined Military Hospital, Lahore, Pakistan. A total of 160 neonates suspected of sepsis were enrolled, including 80 with confirmed sepsis (culture-proven or clinically defined) and 80 without sepsis. Positive cases were further classified into mild (n = 46) and severe (n = 34) sepsis. Independent- samples t-test was used to calculate p-values. NRBCs, total leucocyte count (TLC), mean corpuscular (MCH), lactate, and C-reactive protein (CRP) were higher in neonates with sepsis, with NRBCs showing the highest area under the curve (AUC) for distinguishing severe from mild sepsis. Furthermore, NRBCs showed sensitivity and specificity of 88.2% and 43.5% for a cut-off value of >4.5/100RBCs, respectively. Key Words: Lactate, Neonatal sepsis, Nucleated red blood cells, Severe sepsis.