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血培养阳性新生儿败血症中的血液学异常

Hematological Abnormalities in Culture Positive Neonatal Sepsis.

作者信息

Adane Tiruneh, Worku Minichil, Tigabu Abiye, Aynalem Melak

机构信息

Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Pediatric Health Med Ther. 2022 Jun 7;13:217-225. doi: 10.2147/PHMT.S361188. eCollection 2022.

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.

摘要

背景

在新生儿败血症中,贫血、白细胞增多、血小板减少和凝血时间缩短是最常见的血液学异常。然而,关于新生儿败血症血液学异常的信息不足。因此,我们旨在确定新生儿败血症血液学异常的程度。

方法

这是一项横断面研究,纳入了2020年9月至2021年11月在贡德尔大学专科医院确诊为败血症的143例1至28天的新生儿。使用预先测试的结构化问卷收集社会人口学数据,使用数据收集表收集临床和实验室数据。使用真空采血管采集装置采集2 mL静脉血用于全血细胞计数(CBC)和血培养分析。采用单因素和多因素逻辑回归模型研究新生儿败血症血液学异常的相关因素。当p值小于0.05时具有统计学意义。

结果

新生儿败血症中贫血、血小板减少和白细胞减少的患病率分别为49%(95%CI:40.89 - 57.06)、44.7%(95%CI:36.8 - 52.9)和26.6%(95%CI:22.01 - 29.40)。另一方面,白细胞增多和血小板增多的发生率分别为7.7%(95%CI:4.35 - 13.25)和11.9%(95%CI:7.56 - 18.21)。女性(比值比:3.3;95%CI:1.20 - 3.82)和年龄小于7天(比值比:2.44;95%CI:1.6 - 6.9)被发现是贫血的重要预测因素。

结论

新生儿败血症中贫血、白细胞减少和血小板减少的程度较高。此外,女性和年龄小于7天是贫血的危险因素。因此,贫血、白细胞减少和血小板减少的诊断和治疗可预防新生儿败血症的进一步并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e33/9188337/da010ebe1aa9/PHMT-13-217-g0001.jpg

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