Abstract

REYNA-FIGUEROA, Jesús; BRISENO-VAZQUEZ, Rafael  and  ORTIZ-IBARRA, Federico Javier. Diagnosis of nosocomial sepsis in neonates under 1 500 g by means of NOSEP-I score. Bol. Med. Hosp. Infant. Mex. [online]. 2005, vol.62, n.5, pp.321-328. ISSN 1665-1146.

Introduction. NOSEP-1 score was developed by Mahieu et al, to predict nosocomial sepsis in neonatal intensive care unit patients based on 3 laboratory, 1 clinical, and 1 historical variables potentially related with nosocomial infections. Material and methods. NOSEP-1 score had 5 items including: C reactive protein, neutrophil fraction, thrombocytopenia, fever and parenteral nutrition. We evaluated the NOSEP score in premature patients lower than 1 500 g to predict nosocomial sepsis in the Neonatal Intensive Care Unit of Instituto Nacional de Perinatologia. Validity was evaluated using receiver operating characteristic curve (ROC), sensitivity, specificity, positive predictive value and negative predictive value. Gold standard was the blood culture and 2 or more features of systemic inflammatory response syndrome.We analyzed 2 groups of patients. Group 1:50 new-borns with negative blood culture, and group 2: 52 with positive blood culture, respectively. Results.The point score was 8, with sensitivity of 62.7%, specificity of 70%, positive predictive value of 53.8%, and negative predictive value of 50%. Conclusions. NOSEP-1 score is a simple indicator for detecting nosocomial infections in premature patients; however in the present study analyzing infants < 1 500 g, the sensitivity, specificity, positive predictive value, negative predictive value were lower than original report. We propose that if some of the variables are modified, the specificity may be improved.

Keywords : Cross infection; nosocomial infections; newborn; diagnosis; clinimetric; NOSEP score.

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