Leibovitch Leah, Zohar Hagar, Gavri-Beker Ayelet, Goshen Abigail, Strauss Tzipora
Neonatology, Sheba Medical Center, Tel Hashomer, Israel
Sheba Medical Center, Tel Hashomer, Israel.
BMJ Paediatr Open. 2024 Oct 2;8(1):e002698. doi: 10.1136/bmjpo-2024-002698.
Neonatal sepsis remains a primary cause of morbidity and mortality among newborns. Rapid and accurate diagnosis poses a significant challenge-the non-specific clinical presentation of neonatal sepsis relies heavily on various laboratory indices for early detection and subsequent management. One such indicator under investigation is the mean platelet volume (MPV), which may serve as a predictive marker. This study aims to evaluate the association between the MPV and late-onset sepsis in preterm infants.
This retrospective study included 63 newborns born at Sheba Medical Center from 2016 to 2020 with late-onset sepsis as evidenced by positive blood cultures, and 63 newborns in the control group. We analysed blood count data at three intervals: preinfection, intrainfection and postinfection. Electronic medical records provided supplemental data. Each septic neonate was paired with a non-septic control.
Our results revealed a significant elevation of MPV in septic newborns compared with non-septic controls during the days prior to the infection (9.323 and 8.876, respectively, p=0.043) and persisted up to 2 weeks postinfection (9.39 vs 8.714, p=0.025).The MPV and the MPV-to-total platelet (PLT) count ratio exhibited significant predictive capabilities in receiver operating characteristics analysis (-0.60 and -0.57, respectively).
High MPV in combination with PLT decrement might be predictive for the diagnosis of late-onset sepsis. Future studies should be conducted in order to better understand the underlying pathophysiology and the potential clinical applications of these findings.
新生儿败血症仍然是新生儿发病和死亡的主要原因。快速准确的诊断面临重大挑战——新生儿败血症的非特异性临床表现严重依赖各种实验室指标进行早期检测和后续管理。正在研究的一个指标是平均血小板体积(MPV),它可能作为一种预测标志物。本研究旨在评估早产儿中MPV与晚发性败血症之间的关联。
这项回顾性研究纳入了2016年至2020年在舍巴医疗中心出生的63例晚发性败血症新生儿,血培养阳性证明了这一点,以及63例对照组新生儿。我们分析了三个时间段的血细胞计数数据:感染前、感染期间和感染后。电子病历提供了补充数据。每个败血症新生儿与一个非败血症对照配对。
我们的结果显示,与非败血症对照组相比,败血症新生儿在感染前几天的MPV显著升高(分别为9.323和8.876,p=0.043),并持续到感染后2周(9.39对8.714,p=0.025)。在受试者工作特征分析中,MPV和MPV与总血小板(PLT)计数之比表现出显著的预测能力(分别为-0.60和-0.57)。
高MPV与PLT减少相结合可能对晚发性败血症的诊断具有预测作用。未来应开展研究,以更好地了解这些发现的潜在病理生理学和临床应用。