Background Bacterial sepsis is the main cause of morbidity and mortality in neonates. Early diagnosis and appropriate treatment for the condition can reduce mortality rates. Blood cultures are the gold standard to diagnose bacterial sepsis, but they require 3-5 days for results, whilst the disease may progress rapidly in neonates. Examination of immature-to-total neutrophil ratio (I/T ratio) in peripheral blood smears is a quicker and less expensive method to diagnose bacterial sepsis in neonates. Some studies found the sensitivity of I/T ratio to be 88%-90% in predicting bacterial spesis.Objective To assess the usefulness of the I/T ratio as an early diagnostic tool for neonatal bacterial sepsis.Methods This cross-sectional study was conducted from February to March 2011. Subjects were collected by consecutive sampling. Fifty-three neonates suspected to have bacterial sepsis in the Perinatology Unit at H. Adam Malik Hospital were included. Subjects underwent routine blood examinations, C-reactive protein level measurements, blood cultures, and peripheral blood smears. All statistical analyses were conducted with SPSS (version 16.0 for Windows).Results Of the 53 subjects, 26 had bacterial sepsis based on blood cultures. The I/T ratio had a sensitivity of 88.46%, specificity 81.84%, positive predictive value 82.14%, and negative predictive value 88%. The receiver operating characteristic curve showed a cut-off point of 83.3 (95%CI 71.3 to 95.3)%.Conclusion The I/T ratio may be a good alternative to blood cultures as an early indicator of bacterial neonatal sepsis, as it is faster, less expensive and has good sensitivity and specificity.
Bakteriuria asimtomatik adalah bakteriuria bermakna pada anak yang kelihatan sehat tanpa gejala klinis infeksi ginjal dan saluran kemih. Tujuan penelitian ini untuk melihat perbedaan dan prevalensi bakteriuria asimtomatik pada anak sekolah dasar usia 9 -12 tahun menurut jenis kelamin. Telah dilakukan penelitian secara studi cross sectional deskriptif terhadap urin murid sekolah dasar laki-laki dan perempuan usia 9 -12 tahun di Kecamatan Medan, Tuntungan, Medan yang dipilih secara acak pada bulan Januari sampai Maret 2001. Kriteria eksklusi apabila dijumpai anak dengan gejala infeksi saluran kemih, enuresis nokturnal atau diurnal, sedang menderita kelainan anatomi dan fungsional saluran urogenital yang dapat dideteksi secara klinis. Sampel yang diambil adalah urin pagi pancar tengah dan dibiakkan di Laboratorium Mikrobiologi FK-USU Medan. Bakteruria bermakna bila ditemukan > 100.000 koloni bakteria per ml urin. Dari 200 anak (137 perempuan, 63 laki-laki) dijumpai 16 bakteriuria bermakna terdiri dari 14 (7%) perempuan dan 2 (1%) laki-laki, berbeda bermakna (p<0,05). Jenis bakteriuria E. coli 6, Staphylococcus epidemidis 6, Staphylococcus aureus 2, Klebsiella 1, dan Pseudomonas 1. Kesimpulan, adanya perbedaan bermakna bakteriuria asimtomatik pada anak sekolah dasar laki-laki dan perempuan usia 9-12 tahun, dengan kuman penyebab terbanyak E. coli dan Staphylococcus epidermidis.Kata kunci : bakteriuria asimtomatik, infeksi saluran kemih, urin pancar tengah Sari Pediatri, Vol. 3, No. 2, September 2001: 67 -71 nfeksi saluran kemih (ISK) merupakan penyebab kedua morbiditas penyakit pada anak setelah infeksi saluran nafas.1-3 Pada anak ISK sering tidak terdiagnosis. Pada sebuah penelitian di Portsmouth dan South East Hampshire, Inggris, angka kejadian ISK 20 kali lebih banyak dari yang diyakini sebelumnya.4,5 ISK dapat dibagi atas simtomatik dan asimtomatik. Disebut simtomatik bila dijumpai bakteriuria bermakna disertai gejala klinis seperti sakit buang air kecil (BAK), sering BAK dan rasa ingin miksi terus menerus dengan atau tanpa demam dan nyeri pinggang.
Background Low birth weight has been associated with
Background Measurement of blood pressure is the most impor-tant tool for early detection of hypertension. There is an assump-tion that salt consumption of the population living at the seashoreis higher than that of those living on the hill area, and it would leadto higher blood pressure.Objective To find out whether there is any difference of bloodpressure between school-age children (6-13 years) living on thehill area (Brastagi subdistrict) and those living at the seashore area(Pantai Cermin sub district), North Sumatra.Methods A cross sectional study was conducted in Brastagi andPantai Cermin from September to October 1995. The subjects weretaken by a simple random sampling method. The blood pressurewas measured based on recommendation of The Second TaskForce on Blood Pressure Control in Children 1987.Results The means systolic pressure in boys of 6 years of age aswell as in girls of 6,8,12 and 13 years, and the means of diastolicpressure in girls of 6,7,8,11 years were higher in Pantai Cermin(p<0.05). Blood pressure had significant positive correlations(p<0.001) with age, weight and height in both areas. Overall, hy-pertension was found in 117 (11%) out of 1065 children, 11.6%among girls and 10.6% among boys. On the hill and at seashorearea, hypertension was found in 10.2% and 11.8% of children re-spectively, which was not statistically different (p>0.05).Conclusion In children, there was no significant difference be-tween the prevalence of hypertension on hill and seashore area
Background Urinary tract infection (UTI) are due to pathogeninvasion of the urinary tract. The upper or lower tract may beaffected, depending on the presence of infection in the kidney,or bladder and urethra. Infection of urinary tract affect up to10% of children and are the most common bacterial infection ininfants and young children worldwide. The prevalence of UTI is3-5% in girls and 1 % in boys. Urine culture is considered to bethe gold standard diagnostic test for UTI. However, Gram stainsof uncentrifuged urine have been done in rural health centers andlaboratories in peripheral areas that lack facilities to evaluate urinespecimens. Gram stains of urine may be an effective method forruling out UTI in rural health center patients, thus saving timeand money in impoverished settings.Objective To compare urine Gram stain and urine culture asdiagnostic tests for UTI in children.Methods This cross-sectional study was held in H. Adam MalikHospital from May to June 2010. The 54 participants were aged0 - 14 years, suspected to have UTI and recruited by consecutivesampling. Urine was collected after the external urethral orificewas cleaned. A drop of the urine specimen was Gram stainedand examined by a light microscope, while the remainder of thespecimen was used for laboratory urine cultures. If Gram negativebacteria were observed by Gram stain, we considered the subjectto have UTI.Results The sensitivity and specificity of urine Gram staincompared to urine culture were 88% and 100%, respectively. Thepositive predictive value (PPV) and negative predictive value(NPV) were 100% and 90%, respectively.Conclusion Urine Gram stain may be a good alternative to urineculture for diagnosing UTI in children living in areas with limitedhealth care facilities.
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