Frequency and Severity of Thrombocytopenia in Neonatal Sepsis

Arabdin, Maria; Khan, Adnan; Zia, Sikandar; Khan, Sarbiland; Khan, Gulrukh S; Shahid, Maryam

doi:10.7759/cureus.22665

Cited by 6 publications

(7 citation statements)

References 24 publications

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“…Their findings showed that a neutrophil-to-lymphocyte ratio (NLR) of 6.76 was determined as the predictive cut-off value for EOS, with a In the current study, we observed a correlation between thrombocytopenia and culture-positive sepsis. Previous studies on predictive laboratory indices for sepsis have also demonstrated a relationship between thrombocytopenia and neonatal sepsis (16,17). Our study showed no significant relationship between the type of microorganism (Gram-positive bacteria, Gram-negative bacteria, and fungus) and the number of platelets (P = 0.109).…”

Section: Discussioncontrasting

confidence: 50%

Diagnostic Values of Blood Indices for Neonatal Sepsis

Saeedi,

Mirnia,

Ghassemzadeh

et al. 2024

Arch Clin Infect Dis

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Background: Sepsis is the leading cause of death in newborns, particularly in underdeveloped countries. Early diagnosis and appropriate treatment are critical in reducing neonatal mortality. Since blood culture results are often unavailable for 48 - 72 hours, other hematologic findings may provide useful information for early diagnosis. Objectives: We examined the relationship between neonatal sepsis and blood indices in order to achieve early diagnosis. Methods: In this hospital-based retrospective multiple-event case-control study, we allocated the neonates into three groups: Culture-positive sepsis, culture-negative sepsis, and neonates without sepsis. We compared the lab data within these three groups. Results: The study included 319 neonates: 209 cases of culture-positive sepsis, 65 cases of culture-negative sepsis, and 45 cases without neonatal sepsis. Pearson's test demonstrated a significant correlation between thrombocytopenia, positive C-reactive protein (CRP), and high cell distribution width with culture-positive sepsis (P = 0.000), indicating a statistical difference between the three groups. The mean CRP and eosinophil levels were higher in the culture-positive group with fungal sepsis. Conclusions: In septic neonates with high CRP levels, particularly in conjunction with eosinophilia, fungal coverage should be considered.

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Section: Discussioncontrasting

confidence: 50%

Diagnostic Values of Blood Indices for Neonatal Sepsis

Saeedi,

Mirnia,

Ghassemzadeh

et al. 2024

Arch Clin Infect Dis

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“…In comparison with non‐sepsis patients, sepsis patients had a more severe microcirculation disorder and dynamic decrease in PLT, and their SOFA score significantly increased after admission. This finding implies that when acute infection develops, a sustained inflammatory reaction can result in an increase PLT consumption and a decrease in PLT count 31–33 . Regardless of whether sepsis is ultimately diagnosed, a decrease in PLT count can be detected, but the decrease in PLT is more obvious in the sepsis group.…”

Section: Discussionmentioning

confidence: 97%

“…This finding implies that when acute infection develops, a sustained inflammatory reaction can result in an increase PLT consumption and a decrease in PLT count. [31][32][33] Regardless of whether sepsis is ultimately diagnosed, a decrease in PLT count can be detected, but the decrease in PLT is more obvious in the sepsis group. This is because sepsis has more serious vascular endothelial injury caused by excessive inflammatory reaction, especially the abnormal state of coagulation function characterized by microcirculation disturbance by microthrombosis, which leads to more obvious platelet consumption.…”

Section: Discussionmentioning

confidence: 99%

Sublingual microcirculation and internal environment changes as early indications of sepsis: A prospective observational study

Yang

Teng

et al. 2023

Microcirculation

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Objective This study aims to investigate the changes in microcirculation and internal environment before sepsis in patients with infectious diseases. Methods In this single‐center prospective observational study, all patients did not meet the diagnostic criteria of sepsis 3.0 at admission. Blood samples and sublingual microcirculation were collected at admission, 24 and 48 h after admission. Results A total of 101 patients completed this study. In total, 46 patients met the diagnostic criteria of sepsis 3.0 within 5 days after admission, while the remaining 55 patients did not. The platelet (PLT) was significantly lower in the sepsis patients (195.17 ± 63.89 vs. 242.02 ± 68.59, p = .01), Microvascular Flow Index (MFI) (2.45 ± 0.33 vs. 2.70 ± 0.18, p = .00) and Proportion of Perfused Vessels (PPV) (92.44 ± 4.45 vs. 95.88 ± 3.20, p = .00) were significantly lower, while Flow Heterogeneity Index (FHI) (0.32 ± 0.13 vs. 0.22 ± 0.10, p = .00) was significantly higher in the in the sepsis patients at admission. Decreased levels of MFI (p = .00, OR 0.02, 95% CI: 0.00, 0.15) and PLT (p = .00, OR 0.99, 95% CI: 0.98, 1.00) were independent risk factors for sepsis. Additionally, the 24 h PLT change rate (AUC 0.85, Cutoff −0.17, sensitivity 0.70, specificity 0.93, and Youden index 0.63) suggested a potential early warning effect for sepsis. Conclusion Changes in microcirculation disturbance and the internal environment occurred before sepsis. The MFI and PLT are independent risk factors for sepsis. Sublingual microcirculation and PLT deterioration can be used as early warning indicators before sepsis.

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“… 17 Approximately 75% of neonatal sepsis cases present with reduced PLT levels, which increase mortality almost fourfold. 17 , 20 , 21 Moreover, the MPV/PLT ratio in adult patients with infection is higher than that in neonates, and it is a predictor of the clinical severity and mortality of sepsis; 21 however, this is rarely mentioned in current domestic reports of neonatal infection. This study shows that the proportion of patients with a decreased PLT level in the severe neonatal infection group in the early stage of infection was higher (36.3%) than the proportion in the mild neonatal infection group (2.5%).…”

Section: Discussionmentioning

confidence: 99%

An Analysis of Predictive Factors for Severe Neonatal Infection and the Construction of a Prediction Model

Wang¹,

Wang²,

Li³

2023

IDR

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Objective To investigate the primary predictive factors for the occurrence of severe neonatal infection, construct a prediction model and assess its effectiveness. Methods A total of 160 neonates hospitalised in the Department of Neonatology at Suixi County Hospital from January 2019 to June 2022 were retrospectively analysed. Clinical data was analyzed to determine the primary predictive factors for the occurrence of severe neonatal infection. Predictive efficacy was evaluated using a receiver operating characteristic curve, and a nomogram model was constructed according to the predictors. A bootstrap technique was used to verify the accuracy of the model. Results The neonates were divided, based on the degree of infection, into a mild infection group (n = 80) and a severe infection group (n = 80) according to a 1:1 ratio. Multivariate logistic regression analysis showed that compared with the recovery stage, white blood cell count (WBC) and platelet count (PLT) in the two groups were significantly decreased in the early stage of infection, and the ratio of mean platelet volume to PLT, as well as C-reactive protein (CRP) and procalcitonin levels, was elevated (P < 0.05). The area under the curves (AUCs) of decreased WBC, decreased PLT and elevated CRP levels, and the combination of these three indicators, were 0.881, 0.798, 0.523 and 0.914, respectively. According to the filtered indicators, two models (a dichotomous variable equation model and a nomogram model) of continuous numerical variables were constructed, and their AUCs were 0.958 and 0.914, respectively. The calibration curve of the nomogram model was validated with a consistency index of 0.908 (95% confidence interval [0.862, 0.954]). Conclusion Decreased WBC and PLT levels and an elevated CRP level were the primary independent predictors of severe neonatal infection.

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Frequency and Severity of Thrombocytopenia in Neonatal Sepsis

Cited by 6 publications

References 24 publications

Diagnostic Values of Blood Indices for Neonatal Sepsis

Diagnostic Values of Blood Indices for Neonatal Sepsis

Sublingual microcirculation and internal environment changes as early indications of sepsis: A prospective observational study

An Analysis of Predictive Factors for Severe Neonatal Infection and the Construction of a Prediction Model

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