Effectiveness of Tollner’s Score and Procalcitonin for Diagnosing Neonatal Sepsis


Authors : Viany Rehansyah Putri; Bugis Mardina Lubis; Inke Nadia Diniyanti Lubis;

Volume/Issue : Volume 7 - 2022, Issue 7 - July

Google Scholar : https://bit.ly/3IIfn9N

Scribd : https://bit.ly/3zC33W5

DOI : https://doi.org/10.5281/zenodo.6974466

Gold standard for diagnosing neonatal sepsis is blood culture, but it takes time to get results. Procalcitonin is an acute phase reactant which increases 2 hours after infection. The Tollner’s score, include clinical and laboratory tests, maybe useful for diagnosing sepsis in limited health care facilities. Objective: To determine the effectiveness of Tollner's score and procalcitonin for diagnosing neonatal sepsis. Methods: This cross-sectional study was conducted at Perinatology Haji Adam Malik Hospital Medan from March to July 2021. The sample was neonates who were clinically suspected sepsis. Patients went clinical examination, laboratory, and blood culture and then the Tollner’s score was calculated. The analysis used receiver operating characteristic (ROC) curve to get the cut-off value. Diagnostic tests were performed to assess the effectiveness of the Tollner’s score and procalcitonin. Result: Of 40 neonates, 24 (60%) neonates with positive blood culture. With a cut-off value is 11.8, Tollner’s score obtained a sensitivity value 91.7%, specificity 87.5%, and with a cut-off of 8.5, procalcitonin obtained a sensitivity value 83.3%, specificity 81.2%. There was no significant difference in the Tollner’s score in early and late onset sepsis. Procalcitonin in late-onset sepsis had a statistically significant result (p<0.001) compared to early-onset sepsis (p=0.132). The most common pathogen causing neonatal sepsis in this study was Acinetobacter baumanii as much as 16.7%. Conclusion: Tollner’s score and procalcitonin have good sensitivity and specificity for diagnosing neonatal sepsis so it can be used in limited health care facilities.

Keywords : Tollner’s score, procalcitonin, neonatal sepsis, effectivity.

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