RED CELL CHANGES IN NEONATAL SEPSIS

Abstract

The association of anemia with sepsis in newborns has been suspected for some time. There is little documentation of this association or of its pathophysiology. We studied red cell morphology in newborn infants with clinically suspected septicamia to determine if there are significant changes in red cell shape in association with sepsis in neonates. Red cell morphology has previously been examined using standard dried blood smears. We examined red cell morphology using erythrocyte differential counts(EDC) obtained by 3-dimensional red cell assessment using glutaraldehyde-fixed erythrocytes. Forty babies in a tertiary care nursery were studied. 75% were prematures. Blood cultures from 25 babies with suspected sepsis produced significant bacterial growth(68% S.epi.). Abnormal EDC's were found on examination of red cells from 12 babies. Positive blood cultures were found in 11 of 12 baies with abnormal EDC's.8 of 12 abnormal EDC's showed increased % of echinocytes(26-56% in 6 prematures;& 76.26% in 2 term babies). The 4 remaining abnormal EDC's were: increased spherocytes(7&11%);increased discocytes(72&73%). 10 of the 12 abnormal EDC's were from prematures. No significant association was found between abnormal EDC and asphyxia, hyperbilirubinemia, blood group incompatability, anemia at birth or prior blood transfusion. In conclusion, we have found an association between abnormal EDC and bacterial sepsis in newborns. The relationship of red cell shape changes to the pathophysiology of anemia in septic newborns remains to be determined. A larger experience in the use of EDC as a marker of bacterial sepsis in neonates is required.