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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2019 July-August;178(7-8):544-50

DOI: 10.23736/S0393-3660.18.03880-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Is it possible to differentiate pathogen in neonatal sepsis with thrombocytopenia and high C-reactive protein values?

Halil KAZANASMAZ , Huseyin GUMUS

Department of Pediatrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey



BACKGROUND: Early diagnosis and proper antibiotic selection are very important for neonatal sepsis which leads to major mortality and morbidity problems. Although various laboratory tests and culture samples are helpful for diagnosis, the clinical signs are nonspecific and can be confused with many non-sepsis conditions.
METHODS: This study included term infants with a positive blood culture evidence for neonatal sepsis who were followed in a third degree neonatal intensive care unit between 2015-2017 (N.=187). These patients were divided into two groups as early-onset neonatal sepsis (ENS) and late-onset neonatal sepsis (LNS). In addition, each group was divided into three subgroups as Gram-positive, Gram-negative and candida groups according to the microorganism cultured in each group.
RESULTS: There were 75 patients in the ENS group and 112 patients in the LNS group. There was no significant difference in mean white blood cell, lymphocyte, neutrophil and NLR values between the Gram-positive and the Gram-negative groups in ENS. Mean CRP value was significantly higher in the Gram-negative group and mean platelet value was significantly lower in the Gram-negative group. Mean CRP, neutrophil and NLR values were found to be significantly higher in the Gram-negative group.
CONCLUSIONS: Findings of this study suggest that high CRP, high NLR and severe thrombocytopenia alone may not be sufficient to diagnose ENS and to differentiate the cause according to gram stain, but they may give an idea about causative agent that may grow in cases.


KEY WORDS: C-reactive protein; Neonatal sepsis; Thrombocytopenia

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