Nosocomial sepsis risk score for preterm infants in low-resource settings

Rebecca E. Rosenberg, A. S.M.Nawshad U. Ahmed, Samir K. Saha, M. A.K.Azad Chowdhury, Saifuddin Ahmed, Paul A. Law, Robert E. Black, Mathuram Santosham, Gary L. Darmstadt

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Article numberfmp061
Pages (from-to)82-89
Number of pages8
JournalJournal of tropical pediatrics
Volume56
Issue number2
DOIs
StatePublished - Jul 21 2009

Keywords

  • Developing countries
  • Neonate
  • Nosocomial
  • Prematurity
  • Sepsis
  • Very low birth-weight

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases

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