Am J Perinatol 2016; 33 - A016
DOI: 10.1055/s-0036-1592387

Thrombocytopenia in Neonatal Sepsis Due to Gram-Negative versus Gram-Positive Bacteria

I. Ree 1, S. F. Fustolo-Gunnink 1, V. Bekker 1, A. B. Te Pas 1, E. Lopriore 1
  • 1Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands

Objectives: To estimate the incidence and severity of thrombocytopenia during neonatal sepsis, comparing sepsis caused by gram-positive and gram-negative bacteria.

Methods: A cohort study was performed among all neonates with proven sepsis diagnosed through positive blood culture who were admitted to a tertiary neonatal intensive care unit (NICU) in the Netherlands between 2006 and 2015. The occurrence and severity of thrombocytopenia was recorded, as well as platelet counts, clinical course, major bleedings and potential risk factors for thrombocytopenia.

Results: Sepsis was diagnosed in 461 of 6,551 neonates (7%) admitted to the NICU. A gram-positive bacteria was found in 420 (91%) septic neonates compared with 41 (9%) gram-negative bacteria. Thrombocytopenia (<150*109/L) was detected in 224 (49%) of the 461 septic neonates. In gram-positive sepsis, 47% (197/420) of the neonates showed thrombocytopenia, compared with 66% (27/41) of those with gram-negative sepsis (p = 0.021). Severe to very severe thrombocytopenia (≤50*109/L) was found in 39% (16/41) of neonates with gram-negative sepsis, compared with 19% (76/420) of neonates with gram-positive sepsis (p = 0.001)

Conclusion: The risk for development of thrombocytopenia is more than twofold in gram-negative sepsis compared with gram-positive sepsis. In our study, a linear association was found between the severity of thrombocytopenia and the occurrence of gram-negative sepsis. Gram-negative sepsis is a strong independent risk factor for thrombocytopenia in septic neonates.

This study was supported by the RFBR grants 15-34-70014 and 15-54-45036.