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Updated: May 31, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Correlation of MPV/Platelet Count Ratio With Blood Culture Positivity in Late-Onset Neonatal Sepsis: Implications for
Naveed Ur Rehman Durrani1, Claire Cowsill, Victoria Knowles
1Author Affiliations: NICU Sidra Medicine, Doha, Qatar (Dr Durrani, Cowsill, Knowles, Sarausos, Gordge, and Siminivas); and Weill Cornell Medicine, Doha, Qatar (Dr Durrani).
Background:
Late-onset neonatal sepsis (LOS) is a major cause of morbidity and mortality. Pathogens damage endothelium and platelets, triggering the release of larger platelets.
Purpose:
To find an association between mean platelet volume (MPV) and the MPV/platelet count ratio (MPR) as a rapid, inexpensive screening tool for LOS.
Methods:
Secondary analysis of a sepsis bundle study (Level IV neonatal intensive care unit, January-December 2023) included nonsyndromic newborns >3 days old undergoing sepsis evaluation. Demographics, MPV, platelet count, and culture results were extracted from the electronic medical record. MPV/platelet count ratio was calculated as MPV (femtolitre [fL]) ÷ platelet count (×109/L). Groups were compared by culture status. Receiver operating characteristic analysis determined the optimal MPR cutoff.
Results:
Of 146 episodes, 33 (22.6%) were culture-positive. The median (interquartile range) gestational age was 30 (28.3-35.5) versus 34.2 (28.4-36.3) weeks (P = .22) and birth weight 1330 (990-2380) versus 1970 (990-2500) g (P = .35). Culture-positive infants had higher MPV (9.7 [8.2-10.5] versus 8.8 [8.1-9.7] fL, P = .029) and MPR (0.045 [0.027-0.068] versus 0.031 [0.021-0.048], P = .017). An MPR >0.03 predicted culture positivity with sensitivity 60.6%, specificity 62.5%, positive predictive value 32.3%, negative predictive value 84.3%, likelihood ratio (LR+) 1.62, LR- 0.63, and area under the curve 0.634 (95% CI 0.521-0.747; P = .018).
Implication For Practice And Research:
MPR > 0.03 is significantly associated with culture-positive LOS and may serve as a simple, rapid adjunctive marker for early diagnosis. Prospective validation is required before routine use.
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