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Platelet Count and Sepsis in Very Low Birth Weight Neonates: Is There an Organism-Specific Response?
Thrombocytopenia is commonly observed in very low birth weight (VLBW) neonates with sepsis. Specific platelet responses to different infectious agents have not been extensively characterized. The objectives of this study were to examine platelet counts and platelet indices in preterm neonates with c...
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| Published in: | Pediatrics (Evanston) 2003-06, Vol.111 (6), p.1411-1415 |
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| creator | Guida, Jack D Kunig, Anette M Leef, Kathleen H McKenzie, Steven E Paul, David A |
| description | Thrombocytopenia is commonly observed in very low birth weight (VLBW) neonates with sepsis. Specific platelet responses to different infectious agents have not been extensively characterized. The objectives of this study were to examine platelet counts and platelet indices in preterm neonates with culture-proven sepsis to determine if there are organism-specific platelet responses.
We analyzed a cohort of all VLBW neonates (birthweight |
| doi_str_mv | 10.1542/peds.111.6.1411 |
| format | article |
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We analyzed a cohort of all VLBW neonates (birthweight <1500 g) born over a 4-year period and admitted to a single level III neonatal intensive care unit (N = 943). Thrombocytopenia was defined as a platelet count <100,000/mm(3). Platelet count, nadir, duration of thrombocytopenia, and mean platelet volume (MPV) were examined during episodes of culture-proven sepsis. Analysis of variance, Kruskal-Wallis, Mann-Whitney U, and chi(2) tests were used to compare groups, and data are expressed as mean +/- standard deviation.
Sepsis was diagnosed in 154 (16%) of 943 patients in the study population. Of the sepsis episodes, 54% were associated with thrombocytopenia and 61% with an elevation in MPV. Infections were grouped by organism type: Gram-positive bacteria (117/154, 76%), Gram-negative bacteria (24/154, 16%), and fungi (13/154, 8%). When compared with patients with Gram-positive sepsis, those with Gram-negative or fungal sepsis had a significantly lower initial platelet count, a lower platelet nadir, a higher incidence of thrombocytopenia, and a greater duration of thrombocytopenia. The decrease in platelet count from baseline was also significantly less in the Gram-positive infections than in the fungal infections. Although there was an overall increase in MPV from baseline, there were no differences between groups.
In our population of VLBW infants, sepsis is frequently associated with thrombocytopenia and an elevation in MPV. However, fungal and Gram-negative pathogens are associated with a lower platelet count and more prolonged thrombocytopenia compared with Gram-positive pathogens. We conclude that common pathogens causing sepsis have different effects on platelet kinetics.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.111.6.1411</identifier><identifier>PMID: 12777561</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>Elk Grove Village, IL: Am Acad Pediatrics</publisher><subject>Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Babies ; Bacterial infections ; Biological and medical sciences ; Birth weight ; Blood ; Blood Cell Count - statistics & numerical data ; Blood platelets ; Candidiasis - blood ; Candidiasis - microbiology ; Diseases ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; Escherichia coli Infections - blood ; Escherichia coli Infections - microbiology ; Female ; Gram-Positive Bacterial Infections - blood ; Gram-Positive Bacterial Infections - microbiology ; Humans ; Infant, Newborn ; Infant, Premature, Diseases - blood ; Infant, Premature, Diseases - microbiology ; Infant, Very Low Birth Weight - blood ; Infants (Premature) ; Intensive care medicine ; Intensive Care Units, Neonatal - statistics & numerical data ; Klebsiella Infections - blood ; Klebsiella Infections - microbiology ; Male ; Medical sciences ; Mothers - statistics & numerical data ; Pathogens ; Pediatrics ; Physiological aspects ; Platelet Count - statistics & numerical data ; Premature infants ; Pseudomonas Infections - blood ; Pseudomonas Infections - microbiology ; Sepsis ; Sepsis - blood ; Sepsis - microbiology ; Staphylococcal Infections - blood ; Staphylococcal Infections - microbiology ; Thrombocytopenia - blood ; Thrombocytopenia - microbiology</subject><ispartof>Pediatrics (Evanston), 2003-06, Vol.111 (6), p.1411-1415</ispartof><rights>2003 INIST-CNRS</rights><rights>COPYRIGHT 2003 American Academy of Pediatrics</rights><rights>COPYRIGHT 2003 American Academy of Pediatrics</rights><rights>Copyright American Academy of Pediatrics Jun 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c539t-1b427b96667e6cf59db4df1cb4e8bc8414aa312ab709ac247057e97e0abd0ff53</citedby><cites>FETCH-LOGICAL-c539t-1b427b96667e6cf59db4df1cb4e8bc8414aa312ab709ac247057e97e0abd0ff53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14855673$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12777561$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guida, Jack D</creatorcontrib><creatorcontrib>Kunig, Anette M</creatorcontrib><creatorcontrib>Leef, Kathleen H</creatorcontrib><creatorcontrib>McKenzie, Steven E</creatorcontrib><creatorcontrib>Paul, David A</creatorcontrib><title>Platelet Count and Sepsis in Very Low Birth Weight Neonates: Is There an Organism-Specific Response?</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>Thrombocytopenia is commonly observed in very low birth weight (VLBW) neonates with sepsis. Specific platelet responses to different infectious agents have not been extensively characterized. The objectives of this study were to examine platelet counts and platelet indices in preterm neonates with culture-proven sepsis to determine if there are organism-specific platelet responses.
We analyzed a cohort of all VLBW neonates (birthweight <1500 g) born over a 4-year period and admitted to a single level III neonatal intensive care unit (N = 943). Thrombocytopenia was defined as a platelet count <100,000/mm(3). Platelet count, nadir, duration of thrombocytopenia, and mean platelet volume (MPV) were examined during episodes of culture-proven sepsis. Analysis of variance, Kruskal-Wallis, Mann-Whitney U, and chi(2) tests were used to compare groups, and data are expressed as mean +/- standard deviation.
Sepsis was diagnosed in 154 (16%) of 943 patients in the study population. Of the sepsis episodes, 54% were associated with thrombocytopenia and 61% with an elevation in MPV. Infections were grouped by organism type: Gram-positive bacteria (117/154, 76%), Gram-negative bacteria (24/154, 16%), and fungi (13/154, 8%). When compared with patients with Gram-positive sepsis, those with Gram-negative or fungal sepsis had a significantly lower initial platelet count, a lower platelet nadir, a higher incidence of thrombocytopenia, and a greater duration of thrombocytopenia. The decrease in platelet count from baseline was also significantly less in the Gram-positive infections than in the fungal infections. Although there was an overall increase in MPV from baseline, there were no differences between groups.
In our population of VLBW infants, sepsis is frequently associated with thrombocytopenia and an elevation in MPV. However, fungal and Gram-negative pathogens are associated with a lower platelet count and more prolonged thrombocytopenia compared with Gram-positive pathogens. We conclude that common pathogens causing sepsis have different effects on platelet kinetics.</description><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Babies</subject><subject>Bacterial infections</subject><subject>Biological and medical sciences</subject><subject>Birth weight</subject><subject>Blood</subject><subject>Blood Cell Count - statistics & numerical data</subject><subject>Blood platelets</subject><subject>Candidiasis - blood</subject><subject>Candidiasis - microbiology</subject><subject>Diseases</subject><subject>Emergency and intensive care: neonates and children. Prematurity. Sudden death</subject><subject>Escherichia coli Infections - blood</subject><subject>Escherichia coli Infections - microbiology</subject><subject>Female</subject><subject>Gram-Positive Bacterial Infections - blood</subject><subject>Gram-Positive Bacterial Infections - microbiology</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature, Diseases - blood</subject><subject>Infant, Premature, Diseases - microbiology</subject><subject>Infant, Very Low Birth Weight - blood</subject><subject>Infants (Premature)</subject><subject>Intensive care medicine</subject><subject>Intensive Care Units, Neonatal - statistics & numerical data</subject><subject>Klebsiella Infections - blood</subject><subject>Klebsiella Infections - microbiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mothers - statistics & numerical data</subject><subject>Pathogens</subject><subject>Pediatrics</subject><subject>Physiological aspects</subject><subject>Platelet Count - statistics & numerical data</subject><subject>Premature infants</subject><subject>Pseudomonas Infections - blood</subject><subject>Pseudomonas Infections - microbiology</subject><subject>Sepsis</subject><subject>Sepsis - blood</subject><subject>Sepsis - microbiology</subject><subject>Staphylococcal Infections - blood</subject><subject>Staphylococcal Infections - microbiology</subject><subject>Thrombocytopenia - blood</subject><subject>Thrombocytopenia - microbiology</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNpt0sGL1DAUBvAiijuunr1JEBQ8tJu0SdN6kXXQdWFwxF31GNL0tZOlk9QkZd3_3pQZ3B0ZemgJv68vPL4keUlwRhjNz0ZofUYIycqMUEIeJQuC6yqlOWePkwXGBUkpxuwkeeb9DcaYMp4_TU5IzjlnJVkk7bdBBhggoKWdTEDStOgKRq890gb9BHeHVvYWfdQubNAv0P0moK9gTQz59-jSo-sNOIgxtHa9NNpv06sRlO60Qt_Bj9Z4-PA8edLJwcOL_fs0-fH50_XyS7paX1wuz1epYkUdUtLEezd1WZYcStWxum1o2xHVUKgaVVFCpSxILhuOa6lyyjHjUHPAsmlx17HiNHm7--_o7O8JfBBb7RUMgzRgJy94UeQVpjzC1__BGzs5E-8m8rwqalzWJKJ0h3o5gNCms8FJ1YMBJwdroNPx-Jzgoq4xo7PPjvj4tLDV6mjg3UEgmgB_Qi8n70V1sTq06TGr7DBADyKucbk-9Gc7r5z13kEnRqe30t0JgsVcHTFXR8TqiFLM1YmJV_udTM0W2nu_70oEb_ZAeiWHzkmjtL93tGKsjCv-N3oT23KrHcyjtAxOK__g88Hov70U2VI</recordid><startdate>20030601</startdate><enddate>20030601</enddate><creator>Guida, Jack D</creator><creator>Kunig, Anette M</creator><creator>Leef, Kathleen H</creator><creator>McKenzie, Steven E</creator><creator>Paul, David A</creator><general>Am Acad Pediatrics</general><general>American Academy of Pediatrics</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8GL</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20030601</creationdate><title>Platelet Count and Sepsis in Very Low Birth Weight Neonates: Is There an Organism-Specific Response?</title><author>Guida, Jack D ; Kunig, Anette M ; Leef, Kathleen H ; McKenzie, Steven E ; Paul, David A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c539t-1b427b96667e6cf59db4df1cb4e8bc8414aa312ab709ac247057e97e0abd0ff53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Babies</topic><topic>Bacterial infections</topic><topic>Biological and medical sciences</topic><topic>Birth weight</topic><topic>Blood</topic><topic>Blood Cell Count - statistics & numerical data</topic><topic>Blood platelets</topic><topic>Candidiasis - blood</topic><topic>Candidiasis - microbiology</topic><topic>Diseases</topic><topic>Emergency and intensive care: neonates and children. Prematurity. Sudden death</topic><topic>Escherichia coli Infections - blood</topic><topic>Escherichia coli Infections - microbiology</topic><topic>Female</topic><topic>Gram-Positive Bacterial Infections - blood</topic><topic>Gram-Positive Bacterial Infections - microbiology</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature, Diseases - blood</topic><topic>Infant, Premature, Diseases - microbiology</topic><topic>Infant, Very Low Birth Weight - blood</topic><topic>Infants (Premature)</topic><topic>Intensive care medicine</topic><topic>Intensive Care Units, Neonatal - statistics & numerical data</topic><topic>Klebsiella Infections - blood</topic><topic>Klebsiella Infections - microbiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mothers - statistics & numerical data</topic><topic>Pathogens</topic><topic>Pediatrics</topic><topic>Physiological aspects</topic><topic>Platelet Count - statistics & numerical data</topic><topic>Premature infants</topic><topic>Pseudomonas Infections - blood</topic><topic>Pseudomonas Infections - microbiology</topic><topic>Sepsis</topic><topic>Sepsis - blood</topic><topic>Sepsis - microbiology</topic><topic>Staphylococcal Infections - blood</topic><topic>Staphylococcal Infections - microbiology</topic><topic>Thrombocytopenia - blood</topic><topic>Thrombocytopenia - microbiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guida, Jack D</creatorcontrib><creatorcontrib>Kunig, Anette M</creatorcontrib><creatorcontrib>Leef, Kathleen H</creatorcontrib><creatorcontrib>McKenzie, Steven E</creatorcontrib><creatorcontrib>Paul, David A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: High School</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guida, Jack D</au><au>Kunig, Anette M</au><au>Leef, Kathleen H</au><au>McKenzie, Steven E</au><au>Paul, David A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Platelet Count and Sepsis in Very Low Birth Weight Neonates: Is There an Organism-Specific Response?</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2003-06-01</date><risdate>2003</risdate><volume>111</volume><issue>6</issue><spage>1411</spage><epage>1415</epage><pages>1411-1415</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>Thrombocytopenia is commonly observed in very low birth weight (VLBW) neonates with sepsis. Specific platelet responses to different infectious agents have not been extensively characterized. The objectives of this study were to examine platelet counts and platelet indices in preterm neonates with culture-proven sepsis to determine if there are organism-specific platelet responses.
We analyzed a cohort of all VLBW neonates (birthweight <1500 g) born over a 4-year period and admitted to a single level III neonatal intensive care unit (N = 943). Thrombocytopenia was defined as a platelet count <100,000/mm(3). Platelet count, nadir, duration of thrombocytopenia, and mean platelet volume (MPV) were examined during episodes of culture-proven sepsis. Analysis of variance, Kruskal-Wallis, Mann-Whitney U, and chi(2) tests were used to compare groups, and data are expressed as mean +/- standard deviation.
Sepsis was diagnosed in 154 (16%) of 943 patients in the study population. Of the sepsis episodes, 54% were associated with thrombocytopenia and 61% with an elevation in MPV. Infections were grouped by organism type: Gram-positive bacteria (117/154, 76%), Gram-negative bacteria (24/154, 16%), and fungi (13/154, 8%). When compared with patients with Gram-positive sepsis, those with Gram-negative or fungal sepsis had a significantly lower initial platelet count, a lower platelet nadir, a higher incidence of thrombocytopenia, and a greater duration of thrombocytopenia. The decrease in platelet count from baseline was also significantly less in the Gram-positive infections than in the fungal infections. Although there was an overall increase in MPV from baseline, there were no differences between groups.
In our population of VLBW infants, sepsis is frequently associated with thrombocytopenia and an elevation in MPV. However, fungal and Gram-negative pathogens are associated with a lower platelet count and more prolonged thrombocytopenia compared with Gram-positive pathogens. We conclude that common pathogens causing sepsis have different effects on platelet kinetics.</abstract><cop>Elk Grove Village, IL</cop><pub>Am Acad Pediatrics</pub><pmid>12777561</pmid><doi>10.1542/peds.111.6.1411</doi><tpages>5</tpages></addata></record> |
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| source | EZB Electronic Journals Library |
| subjects | Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Babies Bacterial infections Biological and medical sciences Birth weight Blood Blood Cell Count - statistics & numerical data Blood platelets Candidiasis - blood Candidiasis - microbiology Diseases Emergency and intensive care: neonates and children. Prematurity. Sudden death Escherichia coli Infections - blood Escherichia coli Infections - microbiology Female Gram-Positive Bacterial Infections - blood Gram-Positive Bacterial Infections - microbiology Humans Infant, Newborn Infant, Premature, Diseases - blood Infant, Premature, Diseases - microbiology Infant, Very Low Birth Weight - blood Infants (Premature) Intensive care medicine Intensive Care Units, Neonatal - statistics & numerical data Klebsiella Infections - blood Klebsiella Infections - microbiology Male Medical sciences Mothers - statistics & numerical data Pathogens Pediatrics Physiological aspects Platelet Count - statistics & numerical data Premature infants Pseudomonas Infections - blood Pseudomonas Infections - microbiology Sepsis Sepsis - blood Sepsis - microbiology Staphylococcal Infections - blood Staphylococcal Infections - microbiology Thrombocytopenia - blood Thrombocytopenia - microbiology |
| title | Platelet Count and Sepsis in Very Low Birth Weight Neonates: Is There an Organism-Specific Response? |
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