Effect of neonatal sepsis on platelet counts and their indices
DOI:
https://doi.org/10.18203/2349-3291.ijcp20205516Keywords:
Neonatal sepsis, Thrombocytopenia, MPV, Streptococcus aureus, PDWAbstract
Background: Neonatal septicemia is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. Objective of the study was to know the effect of sepsis on platelet counts and their indices.
Methods: The study was carried out over a period of one and half year from December 2015 to July 2017 at Sangmeshwar and Basaveshwar hospital attached to M. R. medical college, Kalaburagi. 100 cases were considered for this study after proper screening for complete blood count (CBC), platelet count and their indices like mean platelet volume, platelet distribution width and C-reactive protein (CRP) and blood culture in neonates admitted in our neonatal intensive care unit (NICU) with proven sepsis.
Results: A total of 100 neonates with blood culture positive for bacterial cases were considered for the study. Early onset septicaemia (59%) was more common than late onset septicaemia (41%). Out of 100 cases 57% cases had growth of gram negative organisms, 40% had growth of gram positive organisms and 3% had growth of fungal. Tachypnea (27%), lethargy (20%) and refusal of feeds (8%) were the commonest clinical presentation followed by, fever (6%), convulsions (5%) and jaundice (5%). 60% neonates had thrombocytopenia of varying severity. Staphylococcus aureus was the most common organism associated with thrombocytopenia (43.3%). Mean platelet volume (MPV) was high in 85% of cases and platelet distribution width (PDW) was high in 96% of cases.
Conclusions: The present study highlights the association of thrombocytopenia, mean platelet volume and platelet distribution width with causative organism in proven neonatal sepsis. Staphylococcus aureus was the most common organism causing thrombocytopenia in our NICU.
References
Stoll BJ, Shane AL. Infections of the neonatal infant. Nelson Textbook of Pediatrics. 1st south Asia ed. Elsevier Publication. 2015;914-5. Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA et al. Late onset sepsis in VLBW neonates. The experience of NICHD in neonatal research network. Pediatr. 2002;10:285-91.
Roberts IA, Murray NA. Neonatal thrombocytopenia: new insights into pathogenesis and implications for clinical management. Curr Opin Pediatr. 2001;13(1):16-21.
Israels SJ, Rand ML, Michelson AD. Neonatal platelet function. Semin Thromb Hemost. 2003;29(4):363-72.
Nathan DG, Orkin SH, Ginsberg D, Look AT, Fisher DE, Lux S. Nathan and Oski's haematology of infancy and childhood. Saunders, 7th edition. 2003.
Murray NA, Roberts IA. Circulating megakaryocytes and their progenitors in early thrombocytopenia in preterm neonates. Pediatr Res. 1996;40(1):112-9.
Wasiluk A. Thrombocytopoiesis in healthy term newborns. J Perinat Med. 2005;33(3):252-4.
Forestier F, Daffos F, Catherine N, Renard M. Developmental hematopoeisis in normal human fetal blood. 1991;77(11):2360-236.
Brown DR, Kutler D, Rai B, Chan T, Cohen M. Bacterial concentration and blood volume required for a positive blood culture. J Perinatol. 1995;15(2):157-9.
Forsteier F, Daffos F, Galactéros F, Bardakjian J, Rainaut M, Beuzard Y, et al. Haematological values of 163 normal foetuses between 18- 30 weeks of gestation. Pediatr Res. 1986;20(4):342.
Stokowski LA. Neonatal thrombocytopenia evaluation and management.
National association of neonatal nurses- 22 annual conference 46. Available at: https://www.medscape.org/viewarticle/553177. Accessed on: 25 July 2020.
Christensen RD, Henrey E, Weidmeier SE. Thrombocytopenia and neutropenia among ELBW neonates. Hematol Rep. 2006;2(10):126-32.
Mhada TV, Fredrick F, Matee MI Massawe A. Neonatal sepsis at Muhimbili National Hospital, Dar es Salaam, Tanzania; aetiology, antimicrobial sensitivity pattern and clinical outcome. BMC Public Health. 2012;12:904.
Nelson RB, Kehl D. Electronically determined platelet indices in thrombocytopenic patients. Cancer. 1981;48(4):954-6.
Charoo BA, Iqbal JI, Iqbal Q, Mushtaq S, Bhat AW, Nawaz I. Nosocomial sepsis-induced late onset thrombocytopenia in a neonatal tertiary care unit: a prospective study. Hematol Oncol Stem Cell Ther. 2009;2(2):349-53.
Ahmad P, Kaith R, Gattoo I, Najar BA, Hussain SQ. Thrombocytopenia as a predictor of neonatal sepsis in very low birth weight babies. Ind J Neonat Med Res. 2015;3(3):7-13.
Guida JD, Kunig AM, Leef KH, McKenzie SE, Paul DA. Platelet count and sepsis in very low birth weight neonates. Pediatrics. 2003;111(6):1411-5.
Bhat SA, Naik SA, Rafiq W, Tariq AS. Incidence of thrombocytopenia and changes in various platelet parameters in neonates with blood culture positive sepsis. Int J Pediatr. 2015;3(19).
Charoo BA, Iqbal JI, Iqbal Q, Mushtaq S, Bhat AW, Nawaz I. Nosocomial sepsis-induced late onset thrombocytopenia in a neonatal tertiary care unit: a prospective study. Hematol Oncol Stem Cell Ther. 2009;2(2):349-53.
Arif SH, Ahmad I, Ali SM, Khan HM. Thrombocytopenia and Bacterial Sepsis in Neonates. Indian J Hematol Blood Transfus. 2012;28(3):147-51.
Gao Y, Li Y, Yu X. The impact of various platelet in- dices as prognostic markers of septic shock. PLoS One. 2014;13:9.
Lee IR, Shin JI, Park SJ, Oh JY, Kim JH. Mean platelet volume in young children with urinary tract infection. Sci Rep. 2015;5:18072.
Guida JD, Kunig AM, Leef KH, McKenzie SE, Paul DA. Platelet count and sepsis in very low birth weight neonates. Pediatrics. 2003;111(6):1411-5.
Guclu E, Durmaz Y, Karabay O. Effect of severe sepsis on platelet count and their indices. Afr Health Sci. 2013;13920:333-8.
Catal F, Tayman C, Tonbul A, Bilici M. Mean platelet volume may simply predict the severity of sepsis in preterm infants. Clin Lab. 2014;60(7):1193-200.
Patrick CH, Lazarchick J. The effect of bacteremia on automated platelet measurements in neonates. Am J Clin Pathol. 2016;93(3):391-4.
