Study of Platelet Count and Platelet Indices in Neonatal Sepsis in Tertiary Care Institute

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Authors

  • Assistant Professor, Department of pediatrics, Dr. Vasantrao Pawar Medical College and Research Centre, Adgaon,Nashik - 422207, Maharashtra, India ,IN
  • PG Resident, Department of pediatrics, Dr. Vasantrao Pawar Medical College and Research Centre, Adgaon,Nashik - 422207, Maharashtra, India ,IN
  • PG Resident, Department of pediatrics, Dr. Vasantrao Pawar Medical College and Research Centre, Adgaon,Nashik - 422207, Maharashtra, India ,IN
  • Assistant Professor cum Statistician, Department of Community Health and Medicine, Dr. Vasantrao Pawar Medical College and Research Centre, Adgaon, Nashik- 422207, Maharashtra, India ,IN

Keywords:

C Reactive Protein (CRP), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW)
Neonatal Sepsis

Abstract

Aims and Objectives: To correlate degree of thrombocytopenia and platelet indices with neonatal sepsis in our NICU set up. Materials and Methods: After taking approval from ethical committee of our institute, we studied total 150 cases over a span of 24 months, from August 2013 to August 2015. Peripheral blood was drawn from all the study subjects under aseptic precautions in EDTA bulb. A complete hemogram was performed using Beckman Coulter. Latex agglutination kit was used for CRP estimation. Different organisms were isolated by Bactecblood culture. Results: Out of 150 neonates 40(26%) cases were sepsis proven, 63 (42%) ases had suspected infection and 47(31%) cases were non infected. Male constituted 84(56%) cases and females constituted 66(44%) cases. 35(87.5%) cases out of proven sepsis were preterm neonates. Out of 40 sepsis proven cases CRP was increased in 31 (77.5%) neonates. Gram negative organisms were more common than gram positive organisms. Pseudomonas was most common organism, and was isolated in 16 (40%) cases. Staphylococcus organism isolated in 7 (17.5%) cases. 23 (57.5%) of sepsis proven cases showed severe degree of thrombocytopenia and was seen mainly with Pseudomonas organisms. In platelet indices PDW was significantly increased in newborns with sepsis. Whereas MPV was also increased in sepsis cases but was not significant. Conclusion: Variation in the degree of thrombocytopenia and platelet indices was seen in neonatal sepsis. Severe degree of thrombocytopenia associated with proven sepsis. PDW was significantly increased in newborns with sepsis. Gram negative organisms were common cause of neonatal sepsis.

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Published

2017-05-22

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Original Research Article

 

References

Stoll BJ, Shane AL. Infections of the neonatal infant. Nelson Textbook of Pediatrics. 1st south Asia ed. Elsevier Publication; p. 914–5.

Wong W, Glader B. Approach to newborn who has thrombocytopenia.Neo Reviews. 2004 Oct; 5(10):e444.

Cloherty JP, Eichenwald EC, Hansen AR, Stark A. Manual of neonatal care. Puopolo KM, editor. Bacterial and Fungal Infections. 7th ed. Wolterskluwer/Lippincott Williams and Wilkins; 624.

Hornik CP, Fort P, Clark RH, Watt K, Benjamin DK, Jr., Smith PB, Manzoni P, Jacqz- Aigrain E, Kaguelidou F, CohenWolkowiez M. Early and late onset sepsis in very-lowbirthweight infants from a large group of neonatal intensive care units. Early Hum Dev. 2012; 88(Suppl 2):S69–74.https://doi.org/10.1016/S0378-3782(12)70019-1

Chandna A, Nagaraj RM, Srinivas M, ShymalaS. Rapid diagnostic tests in neonatal septicaemia. Indian J Pediatrics.1988; 55:947–58. PMid:3235145. https://doi.org/10.1007/ BF02727835

Khatua SP, Das AK, Chaterjee BP, Khatua S, Ghoure B, Saha A. Neonatal Septicemia. Indian J Pediatr. 1986; 53:509–14.PMid:3542818. https://doi.org/10.1007/BF02749537

Gerdes JS. Diagnosis and management of bacterial infections in the neonate. Pediatr Clin North Am. 2004; 51:939–59.PMid:15275982. https://doi.org/10.1016/j.pcl.2004.03.009

Ahmad MS, Waheed A. Platelet count, MPV and PDW in culture proven and probable. Journal of College and Physician and Surgeon, Pakistan. 2014; 24(5):340–4.

Rodwell RL, Leslic AL, Tudehope DI. Early diagnosis of neonatal sepsis using a hematologic scoring system. J Pe diatr. 1988; 112:761–7. https://doi.org/10.1016/S00223476(88)80699-1

Guida JD, Kunig AM, Leef KH, McKenzie SE, Paul DA.Platelet count and sepsis in very low birth weight neonates.Pediatrics. 2003 Jun; 111(6):1411–5.

Franz AR, et al. Reduction of unnecessary antibiotic therapy in newborn infants using IL-8 and CRP as markers of bacterial infection. Pediatric. 1999; 104(3):447–53.

Philip AGS, Hewitt JR. Early diagnosis of neonatal sepsis.Pediatric. 1980; 65(5):1036–41.

Ablin AR, Kushner JH, Murphy A, Zippin C. Platelete numeration in the neonatal period. Pediatrics. 1961; 82:822–3.

Guclu E, Durmaz Y, Karabay O. Effect of severe sepsis on platelet count and their indices. Afr Health Sci. 2013 Jun; 13920:333–8. https://doi.org/10.4314/ahs.v13i2.19

Pierre Tissieres, AgnieszkaOchoda and Jerome Pugim, Innate Immune Deficiency of extremely Premature neonates can be Reversed by Interferon Y, PLoS One.2012; 7(3):e32863. PMid:22427899 PMCid:PMC3299693. https:// doi.org/10.1371/journal.pone.0032863

Krishna BV, Nadgir SD, Tallur SS. Immunoglobulin estimation and CRP detection in neonatal Septicemia. Indian JPM. 2000; 43(1):35–40.

Kumhar GD, Ramachandran VG, Gupta P. Bacteriological analysis of bloodculture isolates from neonates in a tertiary care hospital in India. J Health Popul Nutr. 2002; 20(4):343– 7. PMid:12659415.

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 Jul; 3(19).

Ahmad P, Kaith R, Gattoo I, Najar BA, Hussain SQ. Thrombocytopenia as a predictor of neonatal sepsis in very low birth weight babies. Indian Journal of Neonatal Medicine and Research. 2015 Jul; 3(3):7–13.

Manucha V, Rusia U, Sikka M, Faridi MMA, Madan N.Utility of hematological parameters and C-reactive protein in the detection of neonatal sepsis. J Pediatr and Child Health. 2002; 38:459.https://doi.org/10.1046/j.14401754.2002.00018.x

Arif SH, Ahmed I, Ali SM, Khan HM. Thrombocytopenia and bacterial sepsis in neonates. Indian J Hematol Blood Transfusion. 2012 Sep; 28(3):147–51. PMid:23997450 PMCid: PMC3422386. https://doi.org/10.1007/s12288-0110118-7

Torkman M, Afsharpaiman SH, Hoseini MJ et al. Platelet count and neonatal sepsis: A high prevalence of Enterobacter spp. Singapur Med J. 2009; 50(5):482–5.

Catal F, Tayman C, Tonbul A, Bilici M. Mean platelet volume may simply predict the severity of sepsis in preterm infants. Clinical Laboratory. 2014 Aug; 60(7):1193–200.

Patrick CH, Lazarchick J. The effect of bacteremia on automated platelet measurments in neonates. Am J Clin Pathol.2016; 93(3):391–4.