Utility of Platelet Count and Platelet Indices in the Diagnosis and Prognosis of Neonatal Sepsis: A Prospective Study

Suman Kumhar, Chandan Verma, Nivedita Gupta, Suniti Verma, Pradhyumn Kumar, Ram Narain Sehra

Abstract

Background: Changes in the platelet count, mean platelet volume (MPV), and platelet distribution width (PDW) are useful in the diagnosis of neonatal sepsis; however, these indices have not been extensively studied in neonatal sepsis.

Aim: The objectives of the study were to evaluate platelet indices in the diagnosis and prognosis of neonatal sepsis and the correlation between platelet indices and the type of organism causing sepsis.

Materials and Methods: This prospective, observational study was conducted from June 2018 to July 2019 in the NICU of a tertiary care hospital. Totally, 154 consecutive neonates were included in the study. The neonates were categorized into proven sepsis, probable sepsis, and no sepsis groups. Tests for platelet count, MPV, PDW, C-reactive protein (CRP), and blood culture were done. The results were statistically analyzed. P < .05 was considered significant.

Results: The neonates were classified into proven sepsis (32.5%), probable sepsis (44.8%), and no sepsis (22.7%) groups. Low birth weight, prematurity, and positive CRP were significantly associated with neonatal septicemia (P < .001). Totally, 50 neonates had proven sepsis, and 69 neonates had probable sepsis. Of the 154 neonates, 126 (81.8%) had thrombocytopenia, 118 (76.6%) had a high MPV, and 104 (67.5%) had a high PDW. The most common microorganisms isolated on blood culture were gram-negative bacteria (64%), predominantly Klebsiella (34%). Thrombocytopenia and high MPV and PDW were more prevalent in early-onset sepsis (P < .001). All the neonates who died had high MPV (100%), high PDW (91.7%), and severe thrombocytopenia (75%).

Conclusion: Neonates with culture-proven sepsis had severe thrombocytopenia, a high MPV, and a high PDW, which are indicators of poor prognosis in neonatal sepsis.