FREQUENCY OF THROMBOCYTOPENIA IN PREMATURE NEONATES WITH BACTERIAL SEPSIS

Main Article Content

Khawaja Kamran Wajid
Anwar Zeb
Amir Mohammad
Uswa Matloob
Naila Sardar

Abstract

Objective: To determine the frequency of thrombocytopenia in preterm babies affected with neonatal sepsis.


Methodology: This cross-sectional study was conducted at the department of pediatrics, Lady Reading Hospital Peshawar from March 2021 to June 2021 by non-probability consecutive sampling technique. A total of 385 pre­mature infants with clinical sepsis of Pakistani origin were included. Neonates with congenital malformations were excluded. Age, gender, blood culture, clinical features of neonatal sepsis, thrombocytopenia, and bacterial pattern in blood cultures were recorded. Data analysis was done in SPSS 22. A Chi-square test was applied to stratify thrombocytopenia among age and gender. P<0.05 was considered significant.


Results: The mean age of the participants was 5.32+/-6.4 days. Males were 192(49.9%) and females were 193(50.1%). Thrombocytopenia was present in 168(43.6%) in premature babies suffering from sepsis. Blood culture was positive in 97(25.2%) cases. In 272(70.6%) infant the C-reactive protein level was less than 5. The common clinical feature were respiratory distress (n=246, 63.9%), reluctant to feed (n=243, 63.1%), tachypnea (n=189, 49.1%), vomiting (n=182, 47.3%), cyanosis (n=45.2%) and diarrhea (n=171, 44.4%). Most common type of bacteria were Staph. Aureus (n=78, 22.3%) followed by E.coli (n=66, 18.9%) and Klebsiella Pneumoniae (n=48, 13.7%). Frequency of thrombocytopenia was higher in 1-10 days infants (n=149, 88.7%) than 21-28 days (n=19, 11.3%) and was statistically significant (P=.024).


Conclusion: The frequency of thrombocytopenia is quite higher in neonates suffering from sepsis so the clinicians should be vigilant in the management of thrombocytopenia to prevent serious complications.

Article Details

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1.
Khawaja Kamran Wajid, Anwar Zeb, Mohammad A, Matloob U, Sardar N. FREQUENCY OF THROMBOCYTOPENIA IN PREMATURE NEONATES WITH BACTERIAL SEPSIS. J Postgrad Med Inst [Internet]. 2022 Jun. 30 [cited 2024 Apr. 25];36(2):70-3. Available from: https://jpmi.org.pk/index.php/jpmi/article/view/2939
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References

Afroza S. Neonatal sepsis-a global prob¬lem: an overview. Mymensingh Med J. 2006;15(1):108-14. DOI:0.3329/mmj. v15i1.2.

Mitul AR. Surgical neonatal sepsis in developing countries. J Neonatal Surg. 2015;4(4):41-6.

Amare D, Mela M, Dessie G. Unfinished agenda of the neonates in developing countries: magnitude of neonatal sep¬sis: systematic review and meta-anal¬ysis. Heliyon. 2019;5(9):e02519. DOI:10.1016/j.heliyon.2019.e02519.

Ahmed M, Yasrab M, Khushdil A, Qamar K, Ahmed Z. Neonatal sepsis in a tertia¬ry care hospital: bacteriological profile and its antibicrobial sensitivity. Pak Arm Forc Med J. 2018;68(6):1654-58.

Kollmann TR, Kampmann B, Mazma¬nian SK, Marchant A, Levy O. Pro¬tecting the newborn and young infant from infectious diseases: lessons from immune ontogeny Immunity. 2017;46(3):350-63. DOI:10.1016/j. immuni.2017.03.009.

Carbone F, Montecucco F, Sahebkar A. Current and emerging treatments for neonatal sepsis. Expert Opin Pharma¬cother. 2020;21(5):549-56. DOI:10.10 80/14656566.2020.1721464.

Torres CS, Dupla AM, Pérez DR, Aliaga MY, Rebage MV, editors. Nosocomial Candida infections and thrombocytope¬nia in very low birth weight newborns. An Pediatr (Barc). 2007;67(6):544-47. DOI:10.1016/s1695-4033(07)70801- 9.

Stanworth SJ, Clarke P, Watts T, Ballard S, Choo L, Morris T, et al. Prospective, observational study of outcomes in neonates with severe thrombocytope¬nia. Pediatrics. 2009;124(5):826-34. DOI:10.1542/peds.2009-0332.

Sola VM, Sallmon H, Brown R. New in¬sights into the mechanisms of nonim¬mune thrombocytopenia in neonates. Semin Perinatol. 2009;33(1):43-51. DOI: 10.1053/j.semperi.2008.10.008.

Levit O, Bhandari V, Li F-Y, Shabanova V, Gallagher PG, Bizzarro MJ. Clinical and laboratory factors that predict death in very low birth weight infants presenting with late-onset sepsis. Pediatr Infect Dis J. 2014;33(2):143-6. DOI:10.1097/ INF.0000000000000024.

Roberts IA, Murray NA. Neonatal thrombocytopenia: new insights into pathogenesis and implications for clin¬ical management. Curr Opin Pediatr. 2001;13(1):16-21.

Murray N, Howarth L, McCloy M, Letsky E, Roberts I. Platelet transfu¬sion in the management of severe thrombocytopenia in neonatal inten¬sive care unit patients. Transfus Med. 2002;12(1):35-41.DOI:10.1046/ j.1365-3148.2002.00343.x.

Sindhura Y, Reddy R. A study of neo¬natal thrombocytopenia in Neona¬tal Sepsis. Int J Contemp Med Res. 2017;4(11):2250-2.

Kausar M, Salahuddin I, Naveed A. Examine the Frequency of Thrombo¬cytopenia in Newborns with Neonatal Sepsis. Age (days). Pakistan J Medical Health Sci. 2020;12:4-8.

Tigabu Kebede Z, Matebe YH, Dem¬isse AG, Yimer MA, Mekasha A, Worku A, et al. Hematologic Profiles of Ethi¬opian Preterm Infants With Clinical Diagnoses of Early-Onset Sepsis, Peri¬natal Asphyxia, and Respiratory Dis¬tress Syndrome. Glob Pediatr Health. 2020;7:2333794X20960264.

Arif S, Ahmad I, Ali S, Khan H. Thrombo¬cytopenia and bacterial sepsis in neo¬nates. Indian J Hematol Blood Transfus. 2012;28(3):147-51.

Brown RE, Rimsza LM, Pastos K, Young L, Saxonhouse MA, Bailey M, et al. Ef¬fects of sepsis on neonatal thrombopoi¬esis. Pediatr Res. 2008;64(4):399-404.

Klingenberg C, Kornelisse RF, Buonocore G, Maier RF, Stocker M. Culture-nega¬tive early-onset neonatal sepsis at the crossroad between efficient sepsis care and antimicrobial stewardship. Front Pediatr. 2018;6:1-9. DOI:10.3389/ fped.2018.00285.

Reyes A. Ending the culture of cul¬ture-negative sepsis in the neo¬natal ICU. Revista Chil Infect. 2018;35(2):216-7. DOI:10.4067/ s0716-10182018000200216.

Hofer N, Müller W, Resch B. The role of C-reactive protein in the diagnosis of neonatal sepsis. Neonatal Bacterial In¬fect. 2013;3:45-58.

Brown JVE, Meader N, Clemin¬son J, McGuire W. C-reactive pro¬tein for diagnosing late-onset in¬fection in newborn infants. Cochran Databa Syst Rev. 2019(1):CD012126. DOI:10.1002/14651858.CD012126. pub2.

Polin RA, Saiman L. Nosocomial infec¬tions in the neonatal intensive care unit. NeoRev. 2003;4(3):81-9. DOI:10.1542/ neo.4-3-e81.

Najeeb S, Gillani S, Ullah R, ur Rehman A. Causative bacteria and antibiotic re¬sistance in neonatal sepsis. J Ayub Med Coll Abbottabad. 2012;24(3-4):131-4.

Muhammad Z, Ahmed A, Hayat U, Wazir MS, Waqas H. Neonatal sepsis: caus¬ative bacteria and their resistance to antibiotics. J Ayub Med Coll Abbottabad. 2010;22(4):33-6.

Sharma P, Kaur P, Aggarwal A. Staphylo¬coccus aureus-the predominant patho¬gen in the neonatal ICU of a tertiary care hospital in Amritsar, India. J Clin Diagn Res. 2013;7(1):66. DOI:10.7860/ JCDR/2012/4913.2672.