Pustaka Ilmiah Universitas Padjadjaran

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Validitas Eosinopenia Sebagai Penanda Diagnosis Pada Sepsis Neonatal Bakterialis

<p>Penegakan diagnosis sepsis neonatal masih menjadi masalah utama. Eosinofil merupakan penanda infeksi akut yang sudah lama dilupakan, Penurunan jundah eosinofil dalam sirkulasi diduga merupakan respons sekunder terhadap stres yang disebabkan oleic infeksi bakteri akut. Penelitian ini bertujuan untuk mengetahui validitas eosinopenia sebagai penanda diagnosis pada sepsis neonatal bakterialis. Penelitian dilakukan pada bulan Juni7 Juli 2009 di Bagian Ilnnt Kesehatan Anak RS Dr Hasan Sadikin Bandung dengan rancangan crosssectional. Neonatus berusia <28 hart yang dicurigai sepsis diambil sampel darah untuk pemeriksaan jumlah eosinofil dan kultur darah. Analisis statistik dilakukan dengan uji chisquare Pearson dan Mann-Whitney Receiver operating characteristic (ROC) curve digunakan untuk inenentukan cut-off point. Dari 91 subjek yang diikut.sertakan, 56 bayi dikelompokkan sepsis dan 35 bayi kelompok bukan sepsis. Rata-rata persentase eosinofil pada kelompok sepsis 1,16% sedangkan paa’a kelompok bukan sepsis 1,65% dengan perbedaan hermakna (1)=0,005). Persentase eosinofil <0,78% memberikan sensitivitas 69,6% (interval kepercayaan (1K) 95%; 55,9-81,2%), spesifisitas 74,3% (1K 95%; 56,7-87,5%), serta akurasi 71,4%. Disimpulkan eosinopenia merupakan penanda diagnosis sepsis neonatal bakterialis.</p>

<p>Diagnosis ofneonatal sepsis is still a major problem. Eosinophil is a forgotten marker of acute infection, The reduction in the number of circulating eosinophils was assumed as a secondary response to stress caused by acute bacterial infection. The aim of the present study is to assess validity of eosinopenia as a diagnostic marker in neonatal bacterial sepsis. A cross-sectional studywas performed on all neonates aged <28 day old inChildHealth Department Hasan Sadikin General Hospital Bandung between June and July 2009. Blood samples were obtained for eosinophil count and blood culture at the time patient was suspected sepsis. Statistical analysis was done by the Pearson chi-square and Mann-Whitney tests. Receiver operating. characteristic (ROC) curve was used to determine the cut-offvalue of eosinophil count. A total of 91 patients were enrolled, 56 neonates were classified as sepsis group and 35 neonates as non-sepsis group. Sepsis group had a mean percentage of eosinophil of 1.16%versus 1.65%in non-sepsis group; it showed stknificant differenceWarmWhitney test, p=0.005). Eosinophil at <0,78% yielded a sensitivity of 69.6% (95% CI, 55.9-81_2%), a specificity of 74.3% (95% CP 56.787.5%), and accuracy of 71.4%. Eosinopenia is a diagnostic marker ofneonatal bacterial sepsis.</p>