Thrombocytopenia and other hematological parameters in culture positive neonatal sepsis and their impact

Abstract

The study has been conducted in neonatal intensive care unit of Sher-i-Kashmir Institute of Medical Sciences, which is a tertiary care hospital. Thrombocytopenia and other hematological abnormalities are very commonly observed in neonatal infections. The objective of the study is to determine the frequency and severity of thrombocytopenia and other hematological abnormalities in neonatal sepsis of different microbiological origins, and their impact on morbidity and mortality. During a period of five years we studied all the newborn babies admitted, with the diagnosis of sepsis, in neonatal intensive care unit. In every sepsis positive patient we observed neutrophil count, micro ESR, C-reactive protein, severity and duration of thrombocytopenia and their relation with the patient's hospital course, morbidity and mortality. Of 194 Culture positive cases 49 (25.25%) cases had leucopenia with 100% mortality; 93 (47.93%) had thrombocytopenia with mortality directly proportional to severity of thrombocytopenia. In neonates with fungal and Gram-negative sepsis thrombocytopenia was comparatively severe and prolonged. Different pathogens causing sepsis have different effects on hematologic parameters. Neonatal sepsis is frequently associated with thrombocytopenia. Neonatal sepsis with neutropenia or with thrombocytopenia is associated with higher mortality. These hematological parameters constitute a simple and cost effective diagnostic tool for neonatal sepsis and guide antibiotic therapy, platelet transfusion, blood transfusion and other modalities of treatment.