DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20211405

Thrombocytopenia and thrombocytosis as a predictor of neonatal sepsis: a hospital-based cross-sectional study

N. Shivaramakrishna Babji, Ajay Jayasheel, Nagapraveen Veerapu

Abstract


Background: Hematological changes in sepsis can aid in the early diagnosis of sepsis even before the culture reports are obtained. Of the various hematological parameters, the platelet count can be an early marker for sepsis. This study was carried out to evaluate the role of thrombocytopenia and thrombocytosis as a marker of sepsis in neonates.

Methods: A cross-sectional study was carried out at neonatal intensive care unit (NICU) at a tertiary care center from1st January 2014 to 30th September 2014. During this period,623 neonates had features suggestive of sepsis, of which 190 turned to be having culture-positive sepsis. One hundred and ninety neonates aged between 0 to 28 days of life admitted in NICU with culture-positive sepsis were included in the study. The newborns were categorized based on platelet count and type of organism cultured. Chi square test was used to test statistical significance. P<0.05 was considered statistically significant.

Results: Among 190 participants, 50% had gram-positive organisms in culture, 37.9% had gram-negative sepsis, and 12.1% had fungal sepsis. The prevalence of thrombocytopenia among the participants was 39.47%. There was a statistically significant difference across the type of organism in sepsis (p<0.05). The difference in outcome across the platelet count status was insignificant, with a p=0.391.

Conclusions: The most common organism causing neonatal sepsis was gram-positive organisms, followed by gram-negative organisms and fungus. Thrombocytopenia was present in all forms of neonatal sepsis irrespective of the causation. Hence, thrombocytopenia can be considered as an early marker of neonatal sepsis.


Keywords


Neonatal sepsis, Thrombocytosis, Thrombocytopenia, Hematological changes, Sepsis predictor

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References


Modell B, Berry RJ, Boyle CA, Christianson A, Darlison M, Dolk H, et al. Global regional and national causes of child mortality. Lancet. 2012;380(9853):1556.

Mclntosh N, Helms P, Smyth R, Logan S. Infection and Immunity in The Newborn. Newborn Forfar Arneils Text B Pediartics. 2008;6:319–25.

ISAACS D, BARFIELD C, CLOTHIER T, DARLOW B, DIPLOCK R, EHRLICH J, et al. Late-onset infections of infants in neonatal units. J Paediatr Child Health. 1996;32(2):158–61.

Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late-Onset Sepsis in Very Low Birth Weight Neonates: The Experience of the NICHD Neonatal Research Network. Pediatrics. 2002;110(2):285–91.

Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003;31(4):1250–6.

Boyer KM. Diagnosis of neonatal sepsis. Mead Johnson Symp Perinat Dev Med. 1982;(21):40–6.

Agrawal N, Sethi RS, Chaurasiya OS, Jain V, Sethi A. Thrombocytopenia Vs Thrombocytosis as a Predictor of Outcome in Neonatal Sepsis Original Research Article. People’s J Sci Res. 2018;11(2):22–6.

Corrigan JJ, Ray WL, May N. Changes in the Blood Coagulation System Associated with Septicemia. N Engl J Med. 1968;279(16):851–6.

Neame PB, Kelton JG, Walker IR, Stewart IO, Nossel HL, Hirsh J. Thrombocytopenia in septicemia: The role of disseminated intravascular coagulation. Blood. 1980;56(1):88–92.

Corrigan JJ. Thrombocytopenia: Alaboratory sign of septicemia in infants and children. J Pediatr. 1974;85(2):219–21.

Medline Plus. Platelet count [Internet]. Medical Encyclopedia. 2015 [cited 2020 Dec 5]. Available from: https://medlineplus.gov/ency/article/003647.htm

Kirkwood BR SJ. Essential medical statistics: John Wiley & Sons. 2 ed. Essential medical statistics: 2010. 413–428 p.

BDSS Corp. Released 2020. coGuide Statistics software, Version 1.0, India: BDSS corp.

Storm W. Use of thrombocytopenia for the early identification of sepsis in critically ill newborns. Acta Paediatr Acad Sci Hung. 1982;23(3):349–55.

Rahman S, Hameed A, Roghani MT, Ullah Z. Multidrug resistant neonatal sepsis in Peshawar, Pakistan. Arch Dis Child Fetal Neonatal Ed. 2002;87(1):52–4.

Sundaram V, Kumar P DS. Blood culture confirmed bacterial sepsis in neonates in north Indian tertiary care centre,changes over last decade. Jpn J infect Dis. 2009;62(1):46–50.

Guida JD, Kunig AM, Leef KH, McKenzie SE P DA. Platelet count and sepsis in VLBW neonates. Pediatrics. 2003;3(6 pt 1):1411–5.

Singh SA, Dutta S, Narang A. Predictive clinical scores for diagnosis of late onset neonatal septicemia. J Trop Pediatr. 2003;49(4):235–9.

Parvez Ahmad, Rajnesh Kaith, Imran Gattoo, Bilal Ahmad Najar SQH. Thrombocytopenia as A Predictor of Neonatal Sepsis in Very Low Birth Weight Babies and Its Correlation with Specific Organism Involved: A Hospital Based Observational Study. Indian J Neonatal Med Res. 2015;3(3):7–13.