effect of different infectious organisms on platelet count and platelet indices in VLBW infants with septicemia

ABSTRACT

Preterm and VLBW infants are at increased susceptibility to sepsis with subtle nonspecific initial presentations therefore, they require much vigilance so that sepsis can be identified and treated effectively. Thrombocytopenia with counts less than 100,000 may occur in neonatal sepsis. MPV and PDW have been shown to be significantly elevated in infants with sepsis after 2-3 days of life. Our objectives were to study the effect of different organisms causing neonatal sepsis in VLBW infants on platelet count and platelet indices. Fifty VLBW infants with culture proven neonatal sepsis admitted to the NICU of the neonatal department at Al Galaa Teaching Maternity Hospital were studied prospectively over a six months period. All babies who were suspected of having sepsis had a full sepsis screen and were culture proven, following a full clinical evaluation. Platelet count and platelet indices including PDW and MPV were calculated. The results were statistically analyzed using student t-test. The mortality rate in culture proven sepsis infants in this study was 10%. Thrombocytopenia, defined as platelet count <100.000/mm[3], was observed in 35/50 [70%] of cases. The initial platelet count at the onset of sepsis was statistically significantly higher with gram-positive organisms [190.520 +/- 7.310/mm[3]] than with Gram-negative [121.670 +/- 4.850/mm[3]] and fungal organisms [112.480 +/- 4.100/mm[3]]. The MPV and PDW in newborns with sepsis showed statistically significant increase from base line, and were statistically significantly higher in fungal and Gm - ve sepsis than in Gm + ve sepsis group [p<0.05]. Common organisms causing neonatal sepsis in VLBW infants exert different effects on platelet count and platelet indices