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 journalArticle


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
Issue number2
StatePublished - Jul 21 2009



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

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases

Cite this

Rosenberg, R. E., Ahmed, A. S. M. N. U., Saha, S. K., Chowdhury, M. A. K. A., Ahmed, S., Law, P. A., Black, R. E., Santosham, M., & Darmstadt, G. L. (2009). Nosocomial sepsis risk score for preterm infants in low-resource settings. Journal of Tropical Pediatrics, 56(2), 82-89. [fmp061].