Details
Category: Volume 05 Issue 11 November 2017
Hits: 3058

Title: A Study of Platelet Indices in Neonatal Sepsis from a Rural Tertiary Care Hospital of North India

Authors: Anoop Bhakri, Baljeet Maini, Sudhir Mehta

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.138

Abstract

Objectives: To Study the effect of sepsis on the platelet counts and other platelet indices in neonates.

Patient and Methods: This observational study was conducted prospectively over a period of one year from November 2014 to October 2015in neonatal division of department of Paediatrics, MMIMSR, Mullana. A total of 100 neonates, who had positive septic screen and/or positive blood culture and/or clinical features suggestive of neonatal sepsis, were included in the study and were compared with appropriately matched control of 100 healthy neonates. The complete septic workup along with indices like platelet distribution width (PDW), mean platelet volume (MPV) was also done.  

Results: A total of 100 neonates were enrolled for the study (85 were with positive septic screen/culture proven and 15 were of clinical sepsis). We found that in cases mean platelet count was 1.09 lakh/mm3, mean PDW was 12.1% and MPV was 16.7fL. In control group mean platelet count was 2.70 lakh/mm3, mean PDW 10.8% and MPV was 16.3fl.Difference in these indices was statistically significant (platelet count P value .004, PDW P value < .001, and MPV P value .003). Birth weight and type of onset of sepsis had no effect on platelet indices in septic babies (platelet count P value.341, PDW .560 and MPV .452). Among sepsis cases, no significant difference was found in term and preterm babies as regard to platelet indices. Also, there is no significant effect on platelet count by the type of causative organism.

Conclusion: Low platelet counts, high mean platelet volume and platelet distribution width was observed in sepsis cases with a statistically significant difference as compared to controls.

Keywords: platelet indices, neonatal sepsis.

References

  1. Sanker MJ et al. Sepsis in the newborn. Indian journal of paediatrics. 2008;75 (3):261-66
  2. Aydemir H, piskin N, Akduman D, Kokturk F, Aktar E. 2012; platelet and mean platelet volume kinetics in adult patients with sepsis. Platelets Vol. 26 ,Iss. 4,2015
  3. Schelonka R L, Yoder B A, Desjardins S E, R B, Butler J. Peripheral leukocyte count  and leukocyte indexes in healthy newborn term infants J pediatr1994 Oct;125(4):603-6.
  4. Da silva o, Ohlsson A, Kenyon C; Accuracy of leukocyte indices and CRP for diagnosis of neonatal sepsis; a critical review. pediatr infect dis J 1995;14:362-66
  5. William E Benitz, Michael Y Han, Ashima Madan, pramela Ramachandra- serial serum CRP levels in the diagnosis of neonatal infection.Pediatrics 1998;102;e41
  6. Vander Lelie J, Vondem Borne AK. Increased mean platelet volume in septic-aemia. J clinpathol 1983 june;36(6): 693-6
  7. Bessman J D, Gardner F H .platelet size in thrombocytopenia due to sepsis. Surggynecolobstet 1983 feb;156(2):177-80
  8. Mannan MA1, Shahidullah M, Noor MK, Islam F, Alo D, Begum NA.. Utility of C - reactive protein and haematological para-meters in the detection of neonatal sepsis. Mymensingh med J 2010;19:259-63
  9. Guida JD, Kunig AM, Leef KH, McKenzie SE, Paul DA. platelet count and sepsis in very low birth weight neonates: is there an organism specific response? Pediatrics 2003:111:1411-5
  10. Charoo BA, Iqbal JI, Iqbal Q, Mushtaq S, Bhat AW, Nawaz I.noscomial sepsis induced late onset thrombocytopenia in a neonatal tertiary care unit; a prospective study. Hematoloncol stem cell 2009;2:349-53
  11. Olmez I, Zafar M, Shahid M, Amarillo S, Mansfield R. Analysis of significant decrease in platelet count and thromboc-ytopenia graded according to MCI-CTC, as prognostic risk markers. For mortality and morbidity. J pediatr hematoloncol 2011;33:585-8
  12. Rastogi S, Olmez I, Bhutada A, Rastogi D. Drop in platelet counts in extremely preterm neonates and its association with clinical outcomes. J pediatr hematoloncol 2011;33:580-84
  13. Manzoni P, Mostert M, Gallete P, Gastaldo L. Is thrombocytopenia suggestive of organism specific response in neonatal sepsis? Pediatrint 2009;51:206-10.
  14. Guclu E, Durmaz Y, Karabay O. Effect of severe sepsis on platelet count and their indices. Afr health sci 2013;13:333-8
  15. Guida JD, Kunig AM, Leef KH, et al. Platelet count and sepsis in very low birth weight neonates: is there an organism-specific response? Pediatrics 2003;111: 1411-5.
  16. Bhat MA, Bhat JI, Kawoosa MS, et al. Organism-specific platelet response and factors affecting survival in thrombocy-topenic very low birth weight babies with sepsis. J Perinatol 2009;29:702-8.
  17. Akarsu S, Taskin E, Kilic M, et al. The effects of different infectious organisms on platelet counts and platelet indices in neonates with sepsis: is there an organism-specific response? JTrop Pediatr;51:388-91.
  18. Manzoni P, Mostert M, Galletto P, et al. Is thrombocytopenia suggestive of organism-specific response in neonatal sepsis? PediatrInt 2009;51:206-10.
  19. Storm W. Use of thrombocytopenia for the early identification of sepsis in critically ill newborns. ActaPaediatrAcadSci Hung 1982;23:349-55.
  20. Sheu JR, Hung WC, Wu CH, et al. Reduction in lipopolysaccharide-induced thrombocytopenia by triflavin in a rat model of septicemia. Circulation 1999;99: 3056-62.
  21. Qayyum R, Vaidya D. Platelet Distribution Width is an independent predictor of all-cause and cardiovascular mortality among healthy US adults. Circulation. 2011;124:A1678

Corresponding Author

Dr Baljeet Maini

Associate Professor, Pediatrics, MMIMSR, Mullana

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.