PLATELET COUNT IN CULTURE POSITIVE NEONATAL SEPSIS AND ITS CORRELATION WITH SPECIFIC CAUSATIVE ORGANISM- A PROSPECTIVE COHORT STUDY.

Abstract

Introduction: In neonates admitted with sepsis, thrombocytopenia is one of the common hematological problems encountered. It is commonly seen in both gram negative and gram positive septicemia. Thrombocytopenia may be considered as an important early indicator in prediction of septicemia in neonates admitted in NICU. Methods: This study was conducted in Level IIB NICU of Shri B M Patil Medical College Hospital Vijayapur, Karnataka. Study Design: Prospective Observational study was conducted. Study Duration: 1 year (Jan 2019 – Jan 2020). Inclusion Criteria: Neonates admitted in NICU with Culture Positive Sepsis were included in the study. Exclusion Criteria: Neonates with maternal history suggestive of placental insufficiency and low platelet counts and family history of bleeding disorders. Results: Out of 1250 admissions in NICU, 180 neonates had culture positive sepsis. Among 54% gram negative organisms, Klebsiella pneumonia was the commonest seen in 56% neonates. Among 40% gram positive organism MRSA was the commonest 53% neonates. Among 6% Fungal Sepsis, Candida sp. (100%) isolated. Severe thrombocytopenia was seen in 16% neonates followed by moderate thrombocytopenia (37%), mild thrombocytopenia (28%) and normal platelet count (19%). The total mortality was high (22%) in neonates having sepsis. Mortality was higher in the neonates having severe thrombocytopenia (69%) compared to neonates having moderate thrombocytopenia (30%) (P value <0.001). Klebsiella pneumoniae (60%) was the leading cause of death in the neonates with sepsis. Conclusions: Major cause of mortality in neonates with sepsis was by Gram Negative sepsis followed by Fungal and Gram Positive sepsis. Proportion of thrombocytopenia in neonates admitted with sepsis was high. Thus thrombocytopenia can be considered as one of the earliest nonspecific predictor of sepsis in neonates admitted in NICU and also it associates significantly with the outcome of the septic neonates.