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

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.