Pustaka Ilmiah Universitas Padjadjaran

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Validitas Eosinopenia Sebagai Penanda Diagnosis pada Sepsis Neonatal Bakterialis

Penegakan diagnosis sepsis neonatal masih menjadi masalah utama.Eeosinofil merupakan penanda infeksi akut yang sudah lama dilupakan. Penurunan jumlah eosinofil dalam sirkulasi diduga merupakan respons sekunder terhadap stres yang disebabkan oleh infeksi bakteri akut. Penelltian ini bertujuan untuk mengetahui validitas eosinopenia .sebagai penanda diagnosis pada sepsis neonatal bakterialis. Parathion dilakukan pada bulan Juni-¬Juli 2009 di Bagian Ilmu Kesehatan Anak RS Dr. Hasan Sadikin Bandung dengan rancangan crass-sectional. Neonatus berusia <28 hari yang dicurigai sepsis diambil sampel darah untuk pemeriksaanjumlah eosinofil dan kultur darah. Analisis statistik dilakukan dengan uji chi- square Pearson dare Mann-Whitney Receiver operating characteristic (ROC) curve digunakon untuk menentukan cut-off point Dari 91 subyek yang diikutsertakan. 56 bayi dikelompokkon sepsis dan 35 bayi kelompok bukan sepsis. Rata-rata persentase eosinofil pada kelompok sepsis 1,16% sedangkan pada kelompok bukan sepsis 1.65% dengan perbedaan bermakna (p=0,005). Persentase eosinofil < 0.78% memberikan sensitivitas 69.6% (interval kepercayaan (1K) 95%: 55,9-81,2%), spesifisitas 74.3% (IK 95%; 56,7-87.5%). serta akurasi 71,4%. Disimpulkan eosinopenia merupakan penanda diagnosis sepsis neonatal bakterialis.

Diagnosis of neonatal sepsis is still a major problem. EosinophiI is a forgotten marker of acute infection. The reduction in the number of circulating eosinophIls wan 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 Was study was performed On all neonates aged <28 day old in Child Health 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 off value of eosinophil count. A total of 91 patients were enrolled, 56 neonates were classifiled 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 significant difference(Mann- Whitney test. p= 0.005) Eosinophil at <0,78% yielded a sensitivity of 69.6% (95% Cl. 55.9-81.2%). a specificity of 74.3% (95% Cl, 56.7- 87.5%). and accuracy of 71,4% Eosinopenia is a diagnostic marker of neonatal barterial sepsis.