Hematological Abnormalities in Culture Positive Neonatal Sepsis

Abstract

Background

In neonatal sepsis, anemia, leukocytosis, thrombocytopenia, and a shortened coagulation time are the most common hematologic abnormalities. However, there is inadequate information regarding the hematological abnormalities in neonatal sepsis. Thus, we aimed to determine the magnitude of hematological abnormalities in neonatal sepsis.

Methods

This is a cross-sectional study that included 143 neonates with culture proven sepsis aged 1–28 days from September 2020 to November 2021 at the University of Gondar Specialized Referral Hospital. The sociodemographic data was collected using a pre-tested structured questionnaire, and the clinical and laboratory data was collected using a data collection sheet. A total of 2 mL of venous blood was taken using a vacutainer collection device for the complete blood count (CBC) and blood culture analysis. A univariate and multivariate logistic regression model was used to investigate factors associated with hematological abnormalities in neonatal sepsis. Statistical significance was declared when a p-value was less than 0.05.

Results

The prevalence of anemia, thrombocytopenia, and leucopenia in neonatal sepsis was 49% (95% CI: 40.89–57.06), 44.7% (95% CI: 36.8–52.9), and 26.6% (95% CI: 22.01–29.40), respectively. On the other hand, leukocytosis and thrombocytosis were found in 7.7% (95% CI: 4.35–13.25) and 11.9% (95% CI: 7.56–18.21), respectively. Being female (AOR: 3.3; 95% CI: 1.20–3.82) and being aged less than 7 days (AOR: 2.44; 95% CI: 1.6–6.9) were found to be significant predictors of anemia.

Conclusion

The magnitude of anemia, leucopenia, and thrombocytopenia is high in neonatal sepsis. Furthermore, being female and being younger than 7 days were risk factors for anemia. Thus, the diagnosis and treatment of anemia, leucopenia, and thrombocytopenia prevents further complications in neonatal sepsis.

Keywords:

• anemia
• hematological abnormalities
• neonatal sepsis
• Gondar
• Ethiopia

Abbreviations

CBC, complete blood count; CoNS, coagulase-negative staphylococci; CSF, cerebrospinal fluid; EOS, early-onset sepsis; Hgb, hemoglobin; LOS, late-onset sepsis; NICU, neonatal intensive care unit; NLF-GNR, non-lactose fermenter gram negative road; RBC, red blood cells; TLC, total leukocyte count; WBC, white blood cells.

Data Sharing Statement

All data generated and/or analyzed in this study are available within the manuscript.

Ethics Approval

The study was conducted after approval of the protocol by the Ethical Review Committee (ERC) of School of Biomedical and Laboratory Sciences, the University of Gondar.

Disclosure

The authors declare no conflicts of interest in relation to this work and that there is no conflict of interests regarding the publication of this manuscript.

Additional information

Funding

The authors received no specific funding for this work.