Diagnostic accuracy of the 2004 Indonesian Pediatric Society medical standard of care for neonatal sepsis

• Main Authors: Oki Fitriani, Purnomo Suryantoro, Setya Wandita, Tunjung Wibowo, Ekawaty L. Haksari, Madarina Julia
• Format: Article
• Language: English
• Published: Indonesian Pediatric Society Publishing House 2012-04-01
• Series: Paediatrica Indonesiana
• Subjects: diagnostic test; 2004 IPS medical standard of care; neonatal sepsis
• Online Access: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/324
• ISSN: 0030-9311; 2338-476X

Background Neonatal sepsis is a leading cause of neonatal morbidity and mortality. There are no pathognomonic signs or symptoms to diagnose neonatal sepsis. Blood culture is the standard tool for sepsis diagnosis, but it is not available in most district hospitals. In 2004, the Indonesian Pediatric Society (IPS) developed a medical standard of care to diagnose neonatal sepsis, but its accuracy has not been adequately verified. Objective To evaluate the diagnostic accuracy of the IPS medical standard of care 2004 to diagnose neonatal sepsis. Methods We conducted diagnostic testing at the Perinatal Ward, Dr. Sardjito Hospital, Yogyakarta, from June to November 2010. Inclusion criteria were neonates with signs and symptoms of infection. We excluded neonates with congenital anomalies, blood disorders, or whose mothers received peripartum antibiotic treatment. All neonates were assessed by the 2004 IPS medical standard of care for neonatal sepsis and by blood culture examinations. Results A total of 193 neonates with signs and symptoms of infection were evaluated. The IPS medical standard had a sensitivity of 88% (95% CI 81 to 94), specificity of 17% (95% CI 2 to 25), positive predictive value of 53% (95% CI 45 to 60), negative predictive value of 57% (95% CI 39 to 75), positive likelihood ratio of 1.06 (95% CI 0.94 to 1.19), and negative likelihood ratio of0.71 (95% CI 0.36 to 1.42). Conclusion The 2004 IPS medical standard of care showed adequate sensitivity for diagnosing neonatal sepsis, but its low specificity limits its use as a diagnostic tool. [Paediatr lndones. 2012;52:86-90].