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

Abstract

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.