Enliven: Pediatrics and Neonatal Biology

Introduction:
Neonatal septicemia is a major reason which may lead to an increase in mortality so if diagnosis is made in time and proper management done, it may help in providing adequate antibiotic coverage and preventing the morbidity and mortality of babies.

Aim and Objective:
The primary objective of this study is to find the prevalence of Thrombocytopenia, Mean Platelet Volume(MPV), Platelet Distribution Width (PDW), Plateletcrit, C-reactive Protein (CRP) and serum uric acid (SUA) level among the cases of culture positive and culture negative sepsis and to determine the etiological agents and the mortality rate.

Material and Methods:
A hospital based observational study was conducted during the period from October 2017- August 2019 in NICU. A total of 208 neonates were taken and were divided into cases having culture proven sepsis (n= 57) , probable sepsis (n=47) who met the inclusion criteria along with normal healthy controls (n=104) which were comparable to the study group. All of neonates were subjected to detailed history including maternal history and signs and symptoms of sepsis. Blood investigation for complete blood count including platelet indices , SUA, CRP and blood culture were sent. Neonates born <34 weeks and those born with congenital anomalies were excluded from the study.

Result:
Out of 208 neonates 104 were controls, remaing were cases 57 (54.8%) neonates had culture proven sepsis. Thrombocytopenia was seen in 81.7% of cases. Among cases 34 (32.7%) neonates expired. Platelet counts were low in culture proven cases (p<0.01) with similarly significant results in MPV (p<0.01) and CRP (p<0.01) levels.Most common organism isolated in sepsis was Klebsiella pneumoniae (38%).

Conclusion:
Thrombocytopenia is a common complication associated with neonatal sepsis having a higher mortality rate. MPV,CRP are reliable markers along with PCT, SUA and PDW can be added as an additional tools to detect early onset septicemia.