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A Study of Neonatal Sepsis and its Relation to Thrombocytopenia in Neonates of Tertiary Care Hospital of Western Nepal

Badri Kumar Gupta, Binod Kumar Gupta, Amit Kumar Shrivastava, Laxmi Shrestha and Pradeep Chetri

Introduction: Thrombocytopenia, defined as a platelet count below 150,000 cells/mm3 is a frequent problem in neonatal intensive care units, complicating the clinical course in 22-35% of intensive care admissions. Recently, there has been wide interest in thrombocytopenia and especially the correlation between platelet count and clinically significant bleeding. One of the major cause of thrombocytopenia in neonates is sepsis.

Aims and objectives: The present study aimed to know the incidence of thrombocytopenia in neonatal sepsis and to evaluate the feasibility of neonatal thrombocytopenia as a screening tool for neonatal sepsis.

Materials and methods: This hospital based prospective observational cross sectional study was conducted in Neonatal Intensive Care Unit in Universal College of Medical Sciences, a tertiary care hospital, Nepal over a period of 3 months, from May 2019 to July 2019. A total of 205 Neonates was suspected sepsis under the age of 28 days admitted in NICU, were included in our study.

Results: A total of 205 Neonates was suspected sepsis thrombocytopenia was found 81 (39.5%), in which mild is 50 (24.4%), moderate is 25 (12.2%), severe 6 (2.9%).108(52.68%) were showed in normal vaginal delivery and 97 (47.31%) cases were showed in lower segment cesarean section in thrombocytopenia in mode of delivery.

Thrombocytopenia in weight for age showed that 31 (15.12%) in SGA cases, 171 (83.41%) were showed in AGA cases, 3 (1.46%) cases were showed in LGA. Thrombocytopenia in C-reactive protein showed 113 (55.12%) were seen in positive, 92 (44.87%) were showed in CRP negative. Blood culture was positive in 51 (24.9%) cases. In which Coagulase Negative Staphylococci (CONS) 22 (43.3%) and Kleibsella species 12(23.52%) were the most common Gram positive and Gram negative organisms.

Conclusion: It can be used as a screening tool for NNS as it is an easy and cost effective method.