Organism specific platelet response in neonatal sepsis in neonates weighing ≤1800 gm

Dipal M. Zanzrukiya, Pareshkumar A. Thakkar, Abhishek K. Thakkar


Background: Thrombocytopenia is an important but non-specific marker of severity of neonatal sepsis. Few studies have observed organism-specific response in platelet count, however this finding in not consistently seen in various studies. We carried out this study to look for organism-specific response of platelet count and indices in neonatal sepsis in our setup.

Methods: A prospective analytical study was conducted during December, 2019 to November, 2020 at tertiary care centre of central Gujarat. Neonates weighing ≤1800 gm (n=100) were enrolled according to eligibility criteria. Sepsis screen including TLC, ANC, platelet count, platelet indices, micro ESR, CRP, and blood culture was done. Patients with culture-proven sepsis were divided according to organisms isolated from blood or CSF. Patients were followed up to the final outcome of their hospital stay. Appropriate analytical tests were used for the results.

Results: Out of 100 patients, 69 had culture-proven sepsis, of which 40 (58%) were gram-negative, 21 (30%) were gram-positive and 8 (12%) had fungal sepsis. Of these 48/69 (70%) patients had thrombocytopenia. Of these patients with thrombocytopenia 60%, 30% and 10% in the first sample while 48%, 38% and 16% in the second sample had gram positive, gram negative and fungal sepsis respectively. Commonest organisms isolated were Enterococcus and MRCONS, and thrombocytopenia was not having specific correlation with any particular organism. There was no significant difference between mean and median platelet count of gram-positive, gram-negative, and fungal sepsis.

Conclusions: Thrombocytopenia is significantly associated with neonatal sepsis. The effects of sepsis on platelet count are not organism-specific.


Thrombocytopenia, Neonates, Sepsis

Full Text:



Agarawal R, Deorari A, Paul V, Sankar AS. AIIMS Protocol in Neonatology. 2nd ed. Delhi, India: Noble Vision. 2019;303-15.

Liu L, Chu Y, Oza S, Hogan D, Perin J, Bassani DG et al. National, regional and state-level all causes and cause-specific under-5 mortality in India in 2000-2015: a systematic analysis with implication for the Sustainable Developmental Goals. lancet Glob Heal. 2019;7:e721-34.

Aslam R, Speck ER, Kim M, Crow AR, Bang KW, Nestel FP et al. Platelet Toll-like receptor expression modulates lipopolysaccharide induced thrombocytopenia and tumor necrosis factor-alpha production in vivo. Blood. 2006;107(2):637-41.

Modanlou HDOO. Thrombocytopenia in neonatal infection. Clin pediatr. 1981;20:402-7.

Bhakri A, Maini BMS. A study of Platelet Indices in Neonatal sepsis from a Rural Tertiary Care Hospital of North India. J Med Sci Clin Res. 2017;5:30616-21.

Guida JD, Kunig AM, Leef KH, Mckenzie SE P DA. Platelet count and sepsis in very low birth weight neonates: is there an organism specific response? Pediatrics. 2003;111:1411-5.

Manzoni P, Monstert M GP. Is thrombocytopenia suggestive of organism-specific response in neonatal sepsis? PediatrInt. 2009;51:206-10.

Bhat MA, Bhat JI, Kawoosa MS, Ahmad SM AS. Organism-specific platelet response and factors affecting survival in thrombocytopenic very low birth weight babies with sepsis. J Perinatol. 2009;29:702-8.

Couto RC, Carvalho EA, Pedrosa TM, Pedroso ER, Neto MC BF. A 10-year prospective surveillance of nosocomial infections in neonatal intensive care units. Am J Infect Control. 2007;35:183-9.

Akarsu S, Taskin EKM. The effects of different infectious organisms on platelet count and platelet indices in neonates with sepsis: is there an organism specific response? JTrop Pediatr. 2005;51:388-91.

Benjamin DK Jr, Ross K, McKinney RE Jr, Benjamin DK, Auten R FR. When to suspect fungal infection in neonates: A clinical comparison of Candida albicans and Candida parapsilosis fungemia with coagulase-negative staphylococcal bacteremia. Pediatrics. 2000;106(4):712-8.

Alshorman A, Maghayreh M, Khriesat WSS. The Effect of Neonatal Sepsis on Platelet Count and their Indices. J Med J. 2008;42:82-6.