Evaluation of Platelet Indices and Sepsis Markers in Neonates with Different Types of Sepsis
Platelet Indices and Sepsis Markers in Neonatal Sepsis
DOI:
https://doi.org/10.54393/pjhs.v5i11.2195Keywords:
Neonatal Sepsis, Platelet Indices, C-Reactive Protein, Mean Platelet Volume, Platelet Distribution WidthAbstract
Sepsis in neonates was the main reason for morbidity and mortality globally, primarily in developing countries. The World Health Organization (WHO) approximates that sepsis affects approximately 3 million neonates annually, causing about 750,000 deaths. Platelet indices such as Platelet Crit distribution width (PCT), Platelet Width Volume (PWV), and Mean Platelet Distribution (MPD) were considered major biomarkers for diagnosis. Objective: To evaluate the alterations in platelet indices and septic markers (CRP) in neonates with sepsis as compared to established reference values. Methods: This cross-sectional study was conducted at the Department of Hematology and Transfusion Medicine in the Children's Hospital and University of Child Health Sciences, Lahore, from November 2023 to February 2024. 57 neonates of the Neonatal Intensive Care Unit (ICU) were sampled. Platelet indices, including PCT, PDW, MPV, and C-reactive protein (CRP), were measured using automated hematology analyzers. Data were analyzed by using SPSS V-23.0. One sample T-test was used to compare the means with the reference value. Results: The mean platelet count was significantly lower. MPV and PDW were significantly elevated in neonates with sepsis compared to the reference value, while PCT was considerably lower. CRP levels were significantly elevated in neonates with sepsis. Conclusions: This study concluded that platelet indices and CRP levels were valued biomarkers for diagnosing and treating neonatal sepsis. These well-established inflammatory markers suggest a strong systemic inflammatory response typically associated with sepsis.
References
Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. The Lancet Respiratory Medicine. 2018 Mar; 6(3): 223-30. doi: 10.1016/S2213-2600(18)30063-8. DOI: https://doi.org/10.1016/S2213-2600(18)30063-8
WHO. WHO Global Health Observatory Data Repository. 2020. Available at: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/neonatal-mortality.
Maouia A, Rebetz J, Kapur R, Semple JW. The immune nature of platelets revisited. Transfusion medicine reviews. 2020 Oct; 34(4): 209-20. doi: 10.1016/j.tmrv.2020.09.005. DOI: https://doi.org/10.1016/j.tmrv.2020.09.005
Ree IM, Fustolo-Gunnink SF, Bekker V, Fijnvandraat KJ, Steggerda SJ, Lopriore E. Thrombocytopenia in neonatal sepsis: Incidence, severity and risk factors. PLOS One. 2017 Oct; 12(10): e0185581. doi: 10.1371/journal.pone.0185581. DOI: https://doi.org/10.1371/journal.pone.0185581
Bolat F, Kılıç SÇ, Oflaz MB, Gülhan E, Kaya A, Güven AS et al. The prevalence and outcomes of thrombocytopenia in a neonatal intensive care unit: a three-year report. Pediatric hematology and oncology. 2012 Oct; 29(8): 710-20. doi: 10.3109/08880018.2012.725454. DOI: https://doi.org/10.3109/08880018.2012.725454
Iba T, Watanabe E, Umemura Y, Wada T, Hayashida K, Kushimoto S et al . Sepsis-associated disseminated intravascular coagulation and its differential diagnoses. Journal of Intensive Care. 2019 Dec; 7: 1-3. doi: 10.1186/s40560-019-0387-z. DOI: https://doi.org/10.1186/s40560-019-0387-z
Choi SJ, Ha EJ, Jhang WK, Park SJ. Platelet indices as predictive markers of prognosis in pediatric septic shock patients. Iranian Journal of Pediatrics. 2017 Jun; 27(3). doi: 10.5812/ijp.7212. DOI: https://doi.org/10.5812/ijp.7212
Shaaban HA and Safwat N. Mean platelet volume in preterm: a predictor of early onset neonatal sepsis. The Journal of Maternal-Fetal & Neonatal Medicine. 2020 Jan; 33(2): 206-11. doi: 10.1080/14767058.2018.1488161. DOI: https://doi.org/10.1080/14767058.2018.1488161
Golwala ZM, Shah H, Gupta N, Sreenivas V, Puliyel JM. Mean platelet volume (MPV), platelet distribution width (PDW), platelet count and plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control study. African Health Sciences. 2016 Jul; 16(2): 356-62. doi: 10.4314/ahs.v16i2.3. DOI: https://doi.org/10.4314/ahs.v16i2.3
Panda SK, Nayak MK, Thangaraj J, Das P, Pugalia R. Platelet parameters as a diagnostic marker in early diagnosis of neonatal sepsis-Seeking newer answers for older problems. Journal of Family Medicine and Primary Care. 2022 May; 11(5): 1748-54. doi: 10.4103/jfmpc.jfmpc_1271_21. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1271_21
Assinger A, Schrottmaier WC, Salzmann M, Rayes J. Platelets in sepsis: an update on experimental models and clinical data. Frontiers in Immunology. 2019 Jul; 10: 1687. doi: 10.3389/fimmu.2019.01687. DOI: https://doi.org/10.3389/fimmu.2019.01687
Khadka P, Maharjan G, Chapagain G, JanukaThapaliya, Paudyal P. Economic and Diagnostic Biomarker Tests of Neonatal Sepsis: A Prospective Study from a Tertiary Care Hospital in a Low‐Income Country. BioMed Research International. 2022 Nov; 2022(1): 5166380. doi: 10.1155/2022/5166380. DOI: https://doi.org/10.1155/2022/5166380
Manandhar S, Amatya P, Ansari I, Joshi N, Maharjan N, Dongol S et al. Risk factors for the development of neonatal sepsis in a neonatal intensive care unit of a tertiary care hospital of Nepal. BioMed Central Infectious Diseases. 2021 Jun; 21(1): 546. doi: 10.1186/s12879-021-06261-x. DOI: https://doi.org/10.1186/s12879-021-06261-x
Sands K, Spiller OB, Thomson K, Portal EA, Iregbu KC, Walsh TR. Early-onset neonatal sepsis in low-and middle-income countries: current challenges and future opportunities. Infection and Drug Resistance. 2022 Jan: 933-46. doi: 10.2147/IDR.S294156. DOI: https://doi.org/10.2147/IDR.S294156
Mishra S, Jaiswar S, Saad S, Tripathi S, Singh N, Deo S et al. Platelet indices as a predictive marker in neonatal sepsis and respiratory distress in preterm prelabor rupture of membranes. International Journal of Hematology. 2021 Feb; 113: 199-206. doi: 10.1007/s12185-020-03025-2. DOI: https://doi.org/10.1007/s12185-020-03025-2
Okube OT and Komen M. Prevalence and predictors of neonatal sepsis among neonates admitted at the newborn unit of Kenyatta National Hospital, Nairobi, Kenya. Open Journal of Obstetrics and Gynecology. 2020 Sep; 10(9): 1216-32. doi: 10.4236/ojog.2020.1090114. DOI: https://doi.org/10.4236/ojog.2020.1090114
Toro-Huamanchumo CJ, Cabanillas-Ramirez C, Quispe-Vicuña C, Caballero-Alvarado JA, León-Figueroa DA, Cruces-Tirado N et al. Mean platelet volume in neonatal sepsis: meta-analysis of observational studies. Children. 2022 Nov; 9(12): 1821. doi: 10.3390/children9121821. DOI: https://doi.org/10.3390/children9121821
Agnello L, Vidali M, Lo Sasso B, Giglio RV, Gambino CM, Scazzone C et al. Monocyte distribution width (MDW) as a screening tool for early detecting sepsis: a systematic review and meta-analysis. Clinical Chemistry and Laboratory Medicine (CCLM). 2022 Apr; 60(5): 786-92. doi: 10.1515/cclm-2021-1331. DOI: https://doi.org/10.1515/cclm-2021-1331
Wu J, Li L, Luo J. Diagnostic and prognostic value of monocyte distribution width in sepsis. Journal of Inflammation Research. 2022 Jan: 4107-17. doi: 10.2147/JIR.S372666. DOI: https://doi.org/10.2147/JIR.S372666
Woo AL, Oh DK, Park CJ, Hong SB. Monocyte distribution width compared with C-reactive protein and procalcitonin for early sepsis detection in the emergency department. PLOS One. 2021 Apr; 16(4): e0250101. doi: 10.1371/journal.pone.0250101. DOI: https://doi.org/10.1371/journal.pone.0250101
Eichberger J, Resch E, Resch B. Diagnosis of neonatal sepsis: the role of inflammatory markers. Frontiers in Pediatrics. 2022 Mar; 10: 840288. doi: 10.3389/fped.2022.840288. DOI: https://doi.org/10.3389/fped.2022.840288
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments