Background: Early-onset neonatal sepsis continues to be a major cause of morbidity and mortality. Identifying simple prognostic markers is essential for early risk stratification. Red cell distribution width (RDW), an inexpensive and routinely available parameter in Complete Blood Count (CBC), has been proposed as a useful marker in systemic infections. This study examined the association between RDW levels and blood culture results in early-onset neonatal sepsis. Methods: A descriptive laboratory-based study was conducted between January 2024 till December 2024, involving 250 neonates with clinically suspected early-onset sepsis. Blood samples were analyzed for CBC and cultured for pathogen identification. Results: Of the 250 neonates with positive blood cultures, the pathogens were distributed as follows: Staphylococcus aureus (115 cases), Pseudomonas spp. (35 cases), Candida spp. (35 cases), and Escherichia coli (65 cases). RDW values were significantly elevated, with a mean of 20 ± 2.5%. An RDW threshold ≥17% demonstrated high sensitivity in predicting mortality among septic neonates. Conclusion: The study highlights RDW as a cost-effective, sensitive hematological parameter that can aid in predicting poor outcomes in neonatal sepsis. Incorporation of RDW into standard sepsis evaluation may improve early clinical decision-making and prognosis.

Red cell distribution width · Hematological marker · Blood culture · Neonatal sepsis