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and mortality. There are no pathognomonic signs or symptoms
to diagnose neonatal sepsis. Blood culture is the standard tool for
sepsis diagnosis, but it is not available in most district hospitals. In
2004, the Indonesian Pediatric Society (IPS) developed a medical
standard of care to diagnose neonatal sepsis, but its accuracy has
not been adequately verified.
Objective To evaluate the diagnostic accuracy of the IPS medical
standard of care 2004 to diagnose neonatal sepsis.
Methods We conducted diagnostic testing at the Perinatal
Ward, Dr. Sardjito Hospital, Yogyakarta, from June to November
2010. Inclusion criteria were neonates with signs and symptoms
of infection. We excluded neonates with congenital anomalies,
blood disorders, or whose mothers received peripartum antibiotic
treatment. All neonates were assessed by the 2004 IPS medical
standard of care for neonatal sepsis and by blood culture
Results A total of 193 neonates with signs and symptoms of
infection were evaluated. The IPS medical standard had a
sensitivity of 88% (95% CI 81 to 94), specificity of 17% (95%
CI 2 to 25), positive predictive value of 53% (95% CI 45 to 60),
negative predictive value of 57% (95% CI 39 to 75), positive
likelihood ratio of 1.06 (95% CI 0.94 to 1.19), and negative
likelihood ratio of0.71 (95% CI 0.36 to 1.42).
Conclusion The 2004 IPS medical standard of care showed
adequate sensitivity for diagnosing neonatal sepsis, but its low
specificity limits its use as a diagnostic tool. [Paediatr lndones.
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