Our selection did not take into considerationthe request for blood culture because our objective was to evaluate the NLR as anearly predictor of sepsis because it is known that the diagnosis of sepsis can occurin the absence of a positive blood culture.(38) Additionally, in the health context oflow- and middle-income countries, the availability of specific tests, such as thatfor prolactin, is not guaranteed.(37). This evidence concerns the gene PRL and Sepsis.