TY - JOUR
T1 - Nosocomial sepsis risk score for preterm infants in low-resource settings
AU - Rosenberg, Rebecca E.
AU - Ahmed, A. S.M.Nawshad U.
AU - Saha, Samir K.
AU - Chowdhury, M. A.K.Azad
AU - Ahmed, Saifuddin
AU - Law, Paul A.
AU - Black, Robert E.
AU - Santosham, Mathuram
AU - Darmstadt, Gary L.
N1 - Funding Information:
Thrasher Research Fund; the Office of Health, Infectious Diseases and Nutrition, Global Health Bureau, United States Agency for International Development (USAID) through cooperative agreement award HRN-A-00-96-90006-00 to Johns Hopkins University; and the Saving Newborn Lives program of Save the Children—US through a grant from the Bill & Melinda Gates Foundation.
PY - 2009/7/21
Y1 - 2009/7/21
N2 - Sepsis is a leading cause of mortality for neonates in developing countries; however, little research has focused on clinical predictors of nosocomial infection of preterm neonates in the low-resource setting. We sought to validate the only existing feasible score introduced by Singh et al. in 2003 and to create an improved score. In a secondary analysis of daily evaluations of 497 neonates ≤33 weeks gestational age admitted to a tertiary care NICU in Dhaka, Bangladesh, we tested the Singh score and then constructed and internally validated our own bedside predictive score. The Singh score had low sensitivity of 56.6% but good positive predictive value (PPV) of 78.1% in our sample. Our five-sign model requiring at least one clinical sign of infection (apnea, hepatomegaly, jaundice, lethargy and pallor) had an area under the receiver operating characteristic of 0.70, sensitivity of 77.1%, and PPV of 64.9%. Our clinical sepsis score is the first bedside clinical screen exclusively for hospitalized, very premature neonates in a low-resource setting, and warrants external validation.
AB - Sepsis is a leading cause of mortality for neonates in developing countries; however, little research has focused on clinical predictors of nosocomial infection of preterm neonates in the low-resource setting. We sought to validate the only existing feasible score introduced by Singh et al. in 2003 and to create an improved score. In a secondary analysis of daily evaluations of 497 neonates ≤33 weeks gestational age admitted to a tertiary care NICU in Dhaka, Bangladesh, we tested the Singh score and then constructed and internally validated our own bedside predictive score. The Singh score had low sensitivity of 56.6% but good positive predictive value (PPV) of 78.1% in our sample. Our five-sign model requiring at least one clinical sign of infection (apnea, hepatomegaly, jaundice, lethargy and pallor) had an area under the receiver operating characteristic of 0.70, sensitivity of 77.1%, and PPV of 64.9%. Our clinical sepsis score is the first bedside clinical screen exclusively for hospitalized, very premature neonates in a low-resource setting, and warrants external validation.
KW - Developing countries
KW - Neonate
KW - Nosocomial
KW - Prematurity
KW - Sepsis
KW - Very low birth-weight
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U2 - 10.1093/tropej/fmp061
DO - 10.1093/tropej/fmp061
M3 - Article
C2 - 19622712
AN - SCOPUS:77951643738
SN - 0142-6338
VL - 56
SP - 82
EP - 89
JO - Journal of tropical pediatrics
JF - Journal of tropical pediatrics
IS - 2
M1 - fmp061
ER -