Study of Platelet Parameters with Different Isolated Organism in Neonatal Bacterial Sepsis

Abstract

Background: Thrombocytopenia is a common hematological abnormality observed in neonatal sepsis and considered as early, nonspecific marker of sepsis. The studies related to organism specific platelet response are few. Objective: To assess the prevalence of thrombocytopenia and to study changes in various platelet parameters in relation to different isolated organism. Methods: A prospective observational study involving neonates with 1st episode of culture positive sepsis was done over a period of 18 months. The platelet parameters studied were incidence, degree, duration of thrombocytopenia; mean platelet volume and platelet nadir among neonate with specific organism isolated. Results: Out of 114 culture positive sepsis 31% Klebsiella, 30% Pseudomonas, 13% Citrobacter, 18% CONS, 4% Staphylococcus Aureus (S Aureus) and 3% had Acinetobacter sepsis. Overall prevalence of thrombocytopenia was 88%, of which klebsiella and S. Aureus sepsis observed 100% prevalence of thrombocytopenia followed by 88% pseudomonas, 80% coagulase negative staphylococci (CONS), 75% Acinetobacter and 66% Citrobacter sepsis. The proportion of severe degree of thrombocytopenia (18% Vs 4%), higher MPV (61% Vs 54%) and longer duration of thrombocytopenia (3.63 ± 0.49 Vs 2.95 ± 0.52) was observed more with Gram negative sepsis than with Gram positive sepsis and statistically significant difference in platelet nadir was observed with Gram negative sepsis. Severe degree of thrombocytopenia was seen in 50% neonates with Acinetobacter and 23% with Klebsiella sepsis. Acinetobacter, Klebsiella and Pseudomonas sepsis had higher mean MPV value, longer duration of thrombocytopenia and lowest platelet nadir.  The platelet parameters were less affected with Gram positive organism. Conclusion: Thrombocytopenia is a frequent occurrence in neonates with sepsis especially with Gram negative organism. Sepsis with Acinetobacter, Klebsiella & Pseudomonas organism was associated with prolonged duration, higher MPV and lower platelet count as compared to                    other isolated organisms.