European Journal of Molecular & Clinical Medicine

Abstract

Aim: The aim of the present study is to determine the Platelet Parameters with Different Isolated Organism in Neonatal Bacterial Sepsis.
Methods: This cross sectional prospective observational study was done in the Department of Paediatrics, Government Medical College, Bettiah, West Champaran, Bihar, India from December 2018 to July 2019. Neonate with presence of more than 2 clinical features suggestive of sepsis with positive C - reactive protein (CRP), were enrolled for the study. Baseline neonatal characteristics like gestational age, birth weight, gender, mode of delivery, APGAR score was noted for all enrolled babies. Neonates were examined clinically for primary illness according to standard format. CBC was done by automated cell counter. Blood culture was done by BACTEC method. Platelet parameters studied were platelet count at baseline & at onset of sepsis; degree of thrombocytopenia; duration of thrombocytopenia; mean platelet volume (MPV) and platelet nadir. The platelet count at the onset of sepsis was considered as platelet count coinciding with blood sample showing positive culture report.
Results: Total 100 babies with culture positive sepsis were analyzed. Mean gestational age of study group was 34.98 ± 3.55 weeks; mean birth weight was 1.899 ± 0.72 kg; male: female ratio was 1.22: 1. Mode of delivery was normal vaginal delivery (NVD) in 69% neonates. Mean APGAR score of study group was 7.81 ± 1.33. Our study observed early onset sepsis in 72% babies and Gram negative sepsis in 75% babies. Overall thrombocytopenia was observed in 90% babies with 57% having moderate to severe degree of thrombocytopenia. The proportion of severe degree of thrombocytopenia (17.33% Vs 4%), higher MPV (59.33% Vs 56%) and longer duration of thrombocytopenia (3.78 ± 0.55 Vs 3.02 ± 0.61) was observed more with Gram negative sepsis than with Gram positive sepsis, but statistical significance was not found. We observed statistically significant platelet nadir with Gram negative sepsis. Out of 100 neonates with culture positive sepsis, Gm negative sepsis was observed in (75) 75% and Gm positive sepsis was observed in (25)25%. The proportion of isolated organisms was: 30% klebsiella, 25% pseudomonas, 19% Coagulase- negative Staphylococci (CONS), 14% Citrobacter , 6% S. Aureus & 6% Acinetobacter.
Conclusion: Thrombocytopenia is a frequent occurrence in neonates with sepsis especially with Gram  negative organism.