Mahieu et al developed a bedside score for predicting nosocomial sepsis in a neonate in the neonatal ICU. The authors are from University Hospital of Antwerp in Belgium.
Parameters:
(1) duration of total parenteral nutrition (TPN)
(2) C-reactive protein (CRP)
(3) platelet count
(4) temperature
(5) percent neutrophils in the peripheral blood differential count
Parameter
Finding
Points
duration of TPN
none or < 14 days
0
>= 14 days
6
CRP in mg/L
< 14 mg/L
0
>= 14 mg/dL
5
platelet count
>= 150,000 per µL
0
< 150,000 per µL
5
temperature
<= 38.2°C
0
> 38.2°C
5
percent neutrophils
<= 50%
0
> 50%
3
where:
• The above items were used to generate the NOSEP-1 score.
• The addition of hub catheter and exit site culture results to NOSEP-1 was termed the NOSEP-2.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• The higher the score the greater the risk of nosocomial sepsis.
Performance:
• A score >= 8 was 95% sensitive but 43% specific.
• A score of >= 11 was 60% sensitive and 84% specific.
• A score >= 14 was 26% sensitive and 100% specific.
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