Selimovic et al developed a predictive score for identifying a neonate with early-onset sepsis. The authors are from the University Clinical Center at Tuzla in Bosnia and Herzegovina.


Patient selection: neonate, evaluated for the first time <= 72 hours after birth

Exclusions: major congenital anomaly, inborn error of metabolism, hemolytic jaundice, respiratory distress syndrome related to prematurity, receipt of antibiotic therapy prior to blood culture, born outside of clinic



(1) total white blood cell count in 10^9/L

(2) ratio of immature to total WBC

(3) ratio of immature to mature WBC (where mature = total minus immature)

(4) C-reactive protein (CRP) in mg/L


predictive score =

= (0.01 * (WBC multiplier)) + (5.7 * (ratio of immature to total WBC)) - (2.9 * (ratio of immature to mature)) + (0.01 * (CRP))



• minimum score: 0

• maximum score: around 0.8

• A value >= 0.503 was used to identify an infant with early-onset neonatal sepsis.



• The sensitivity at the cut-off was 73% and specificity 89% with area under the ROC curve of 0.87.


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