Bacterial pneumonia score to identify bacterial pneumonia

Abstract

Background Pneumonia is caused by either bacterial or viral
etiologies, with similar symptoms in children. The bacterial
pneumonia score (BPS) is a clinical assessment comprised of
several investigations: age, assessment of axillary temperature,
absolute neutrophil count, band neutrophil percentage, and
interpretation of radiological examination. The score will use to
differentiate the etiology of pneumonia.
Objective To determine the sensitivity, specificity, positive
predictive value, and negative predictive value of BPS in
identifying bacterial pneumonia in children.
Methods This diagnostic study was performed at Dr. M. Djamil
Hospital, Padang, West Sumatera where subjects were selected by
consecutive sampling. Fifty-seven patients were diagnosed with
pneumonia. Three patients suffered from ventricular septal defects,
8 patients refused to provide blood specimens and 3 patients’
chest X-rays could not be interpreted, hence, 43 subjects were
included in the study. Chest X-rays were interpreted by a pediatric
pulmonology consultant. Leukocyte and differential counts were
performed by a clinical pathology consultant. Subjects’ BPS scores
were compared to multiplex PCR examinations of blood specimens,
as the gold standard.

Result Of 43 subjects, 27 (62.79%) were male. Subjects’ mean age was 29.3 (SD 21.5) months. Twenty (46.51%) subjects had good nutritional status, 4 (9.31%) subjects had axillary temperature ≥39°C, and 22 (51.16%) subjects had absolute neutrophil counts ≥8.000/mm³. Bacterial pneumonia score (BPS) had 69% sensitivity, 60% specificity, 42% positive predictive value, and 81% negative predictive value.

Conclusion In this study, BPS has low sensitivity and specificity
for identifying bacterial pneumonia.