External validation of the clinical score system for early detection of late–onset neonatal sepsis

<ns3:p>Objectives Late-onset neonatal sepsis (LONS) is the leading cause of neonatal mortality. Blood culture as the gold standard has a low sensitivity and is time-consuming. To overcome this concern, Husada D. et al. (2020) have developed a clinical score system to help diagnose LONS. Therefore, we conduct this study to externally validate the clinical score system as a predictor of LONS. Methods This was a validation study with cross-sectional design conducted at Dr. Soetomo Academic General Hospital in Surabaya, Indonesia, from November 1, 2021, to April 31, 2022. The study included all eligible neonates aged more than 7 days who were suspected of suffering LONS in the NICU. Subjects were assessed using Husada D. et al.’s (2020) score system. Neonates with positive blood culture were confirmed sepsis. The validation study calculated sensitivity, specificity, positive predictive value, and negative predictive value. Results Out of 90 subjects included in this study, 28 (31.1%) had a positive blood culture, with gram-positives predominant (19/28, 67.9%). The mean birth weight was 1976.22 ± 791.87 grams, with a mean gestational age of 34.23 ± 3.50 weeks. The area under the curve was 98.8% (<ns3:italic>p</ns3:italic>-value<0.001; 96.9-100.0), which means neonates with LONS will have a higher prediction score. The sensitivity of this tool was 100%, and the specificity was 96.8%. The positive predictive value was 93.3%, while the negative predictive value was 100%. Conclusion This clinical score system is a valid tool that can be used in bedside scoring for early detection of LONS.</ns3:p>