Dignostic Accuracy of the 2004

Indonesian Pediatric Society

Medical Standard of Care for
Neonatal Sepsis
Oki Fitriani, Purnomo Suryanto,
Setya wandita, Tunjung Wibowo,
Eka L. Haksari, Madarina Julia
Pediatricia Indonesiana, vol. 52, no. 2 March 2012

LOGO

BACKGROUND
High
Prevalence

Pathognomonic
Sign & Symptom
(-)

IPS proposed
a medical standard
of care to diagnose
neonatal sepsis
Blood Culture
not always
Available

OBJECTIVE

To evaluate the diagnostic accuracy of

the IPS medical standard of care 2004 to
diagnose neonatal sepsis

METHODS
193 neonates admitted to the
perinatal ward

To evaluate the diagnostic accuracy of

Perinatal
ward of Dr.of
Sardjito
the IPS medical
standard
careHospital,
2004 to
Yogyakarta, Indonesia
diagnose neonatal
sepsis
June - November 2010

Continued.
Inclusion criteria
1.

Neonates with signs & symptoms

of infection

2.

Had no previous antibiotic

treatment

3.

Had parent/guardian consent to

participate in the study

4.

Continued.
Exclusion criteria
1.

Congenital anomaly

2.

Surgical problems

3.

Maternal peripartum antibiotic

treatment

4.

Continued.
Phase
Phase 11

Phase
Phase 22

Phase
Phase 33

To evaluate the diagnostic accuracy of

the IPS medical standard of care 2004 to
Assessed by IPS
diagnose neonatal sepsis
medical standard
193 neonates

of care for
neonatal sepsis

Blood culture

Continued.
Categories B

IPS CRITERIA

Categories A
Difficulty breathing
Shortness of breath
Seizure
Lack of consciousness
Temperature instability
Unsterile delivery process
Deteriorating condition

Lethargy
Reduced activity
Irritability
Vomiting
Bloating
Signs appearing after the 4th of life
Meconium-stained amniotic fluid
Poor feeding

RESULT

To evaluate the diagnostic accuracy of

the IPS medical standard of care 2004 to
diagnose neonatal sepsis

Continued.

Continued.

Continued.

DISCUSSION
Adding
Adding simple
simple laboratory
laboratory examination
examination

To evaluate the diagnostic accuracy of

the IPS medical standard of care 2004 to
diagnose neonatal sepsis
High
sensitivity

Low
specificity

Continued.
Blood
culture(+)51,3%

Gram negative
microorganism
(62,5%)

Continued.
Organism requiring a spesific
methods to isolate

Peripartum maternal
antibiotic theraphy

Previous antibiotic treatment

of the neonates

Errors sampling

Blood
Culture(-)

Methods of blood
sampling

Inappropriate site drawings

CONCLUSION

The 2004 IPS medical standard of care

To evaluate the diagnostic accuracy of
showed adequate sensitivity for
the IPS medical
standard
of care
2004
toits low
diagnosing
neonatal
sepsis,
but
diagnose neonatal
specificitysepsis
its use as a diagnostic tool

LOGO

Pendahuluan
TALASEMIA

300 juta penduduk dunia yg

membawa gen talasemia dan
300.000 nayi dengan talasemia
dilahirkan setiap tahun
Penderita talasemia di Indonesia

8 jt jiwa dan 3000 penderita

baru setiap tahunnya

Merupakan kelompok anemia

hemolitik
kongenital
yang
diturunkan secara autosomal
resesif dimana terjadi defek pada
sintesis rantai polipeptida yang
menyusun molekul globin dalam
hemoglobin

BACKGROUND
Talasemia

Kerusakan dan
kematian sel

Transfusi
rutin
Besi berlebih

ROS