Incidence of thrombocytopenia and changes in various platelet parameters, in blood culture positive neonatal sepsis

Introduction: The aim of this study was to assess the incidence of thrombocytopenia and changes in various platelet parameters in neonates with blood culture positive sepsis. Materials and Methods: This was prospective study conducted over a period of one year in Neonatal Intensive Care Unit of Deen Dayal Upadhyay Hospital (DDUH), in Delhi, North India. All babies who were admitted during the study period were evaluated prospectively for evidence of sepsis. Results: Among 560 neonates, 80/560 (14.28%) had culture positive sepsis. Gram- positive sepsis occurred in 21/80 (26.25%), gram- negative sepsis in 54/80 (67.5%), and fungal sepsis in 5/80 (6.25%). Incidence of thrombocytopenia in gram- negative sepsis was (35/54) 64.81%, in gram- positive sepsis (15/21) 71.41%, and in fungal sepsis was (3/5) 60%. Mean platelet count at the onset of sepsis in all the patients was 123287.5± 49428.68. The mean duration of thrombocytopenia in gram- positive sepsis was 4.66 ±2.6 days, in gram- negative sepsis 4.39 ± 2.22 days and in fungal sepsis 5.2±1.3 days. Mean platelet volume (MPV) at the time of onset of sepsis was high in gram- positive sepsis than in gram- negative sepsis (11.57±0.88 Vs 11.29 ± 0.76). The MPV of thrombocytopenic neonates was significantly higher than of non-thrombocytopenic neonates (P 0.01). Conclusion: In this study, incidence of culture positive sepsis in neonates was 14.28%; thrombocytopenia was present in 66.25% of neonates with sepsis. Thrombocytopenia had 66.25% sensitivity and 87% specificity in predicting sepsis among culture positive patients.