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"ABSTRAKLatar belakang:Sepsis adalah infeksi bakteri dalam darah yang sangat serius (SBI) karena akan mengancam jiwa. Masih tingginya angka kematian balita karena infeksi berat dan keterbatasan fasilitas di rumah sakit daerah untuk mendiagnosis terjadinya SBI,maka penilaian secara klinis dengan menggunakan standar yang valid dalam menegakkan diagnosis SBI sangat diperlukan.Salah satu metode yang dapat digunakan untuk menilai apakah anak diprediksi menderita SBI adalah dengan skala Acute illness observation scale (AIOS). Peneliti terdahulu menemukan skalaAIOS >8 mempunyai titik potong paling baik, tapi validasi keakuratannya perlu diteliti lebih lanjut. Tujuan:Melakukan validasi menggunakan skala AIOS>8 untuk mendeteksi terjadinya infeksi bakteri serius pada usia 3-36 bulan yang datang dengan demam, dan membandingkannya dengan diagnosis akhir dari dokter spesialis anak.Metode :Uji diagnostik potong lintang dan validasi skor menggunakan tabel dua kali dua, untuk mendapatkan nilai sensitifitas, spesifisitas, nilai duga positif, nilai duga negatif dan rasio kemungkinan positif dan negatif. Hasil penelitian :Dari 143 sampel, subjek penderita SBI sebesar 44(30,77%), proporsi anak laki-laki sama dengan perempuan. dan usia terbanyak adalah 3-12 bulan yaitu 27(61,4%) subjek. Subjek penderita SBI dengan skoring AIOS > 8 sebanyak 41( (93,2%%). Penyakit SBI terbanyak adalah pnemonia 21(47,7%) subjek, diikuti ISK (13,6%), diare bakterial, sepsis dan ensefalitis masing masing (9,1%), selulitis (6,8%) dan meningitis (4,6%) dan penyakit bukan SBI terbanyak adalah ISPA 36(36,4%) subjek. Sensitifitas skor AIOS 95,5% (IK 95%; 84,5-99,4%), spesifisitas 29,3% (IK 95%; 20,6-39,3%), nilai duga positif 37,5% (IK 95%; 34,3-40,9%), nilai duga negatif 93,6% (IK 95%; 78,4-98,3%), rasio kemungkinan positif 1,4 (IK95%; 1,2-1,6), rasio kemungkinan negatif 0,2 (IK95%; 0,04-0,6). AUC(area under receiver operating characteristic curve 0,655 dengan p 0,002 dan IK 95% 0,6-0,8) dapat mendiskriminasi pasien-pasien yang dicurigai SBI dengan baik. Kesimpulan : Penggunaan skala AIOS>8 sangat sensitif untuk mendeteksi terjadinya infeksi bakteri serius pada usia 3-36 bulan.

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ABSTRACTBack ground. Sepsis is a very serious bacterial infection in the blood (SBI) because it will be life-threatening. The high rates of under-five mortality due to severe infections and limited facilities in local hospitals, a clinical assessment must be use a valid standard to diagnose SBI. One method that can be used to assess whether a child is predicted to have SBI is the scale of the Acute illness observation scale (AIOS). The previous researcher found that the scale of AIOS > 8 has the best cutoff point, but the validation of accuracy needs to be further investigated.. Aim: Validate using AIOS scale> 8 to detect the occurrence of serious bacterial infections at the age of 3-36 months who come with fever, and compare it with the final diagnosis of pediatrician.Method. The cross-sectional diagnostic test and the scoring validation use the two-by-two tables, to obtain sensitivity, specificity, positive predictor, negative predictor and positive and negative probability ratios. Result. Of the 143 samples, the subject of SBI was 44 (30.77%), the proportion of boys was the same as for women. And the most ages were 3-12 months ie 27 (61.4%) subjects. Subjects of SBI patients with AIOS scores > 8 were 41 ((93.2 %%) .The highest SBI disease was pneumonia 21 (47.7%) subjects, followed by UTI (13.6%), bacterial diarrhea, sepsis and encephalitis respectively (9,1%), cellulitis (6.8%) and meningitis (4.6%) and non-SBI disease were mostly ARI 36 (36.4%) subjects, AIOS score sensitivity 95.5% (95% IK; 84,5-99,4%), specificity 29,3% (95% IK, 20,6-39,3%), positive predictive value 37,5% (95% IK, 34,3-40,9% ), A negative predictive value of 93.6% (95% IK, 78.4-98.3%), a positive likelihood ratio of 1.4 (IK95%, 1.2-1.6), a negative likelihood ratio of 0.2 ( IK95%; 0.04-0.6). AUC (area under receiver operating characteristic curve 0.655 with p 0.002 and 95% IK 0.6-0.8) can discriminate well-suspected SBI patients. Conclusion. The use of AIOS scale> 8 is very sensitive to detect serious bacterial infections at 3-36 months of age in area."

"ABSTRAKLatar belakang. Adanya peningkatan angka kematian anak di negara berkembang, masih tingginya insiden penyakit infeksi bakteri serius (IBS) pada anak, beragamnya variabel klinis yang menjadi faktor risiko terjadinya IBS, model skoring yang ada belum teruji dalam mendeteksi IBS di sarana pelayanan terbatas.Tujuan. Untuk mengetahui validitas Skor RCPCH dalam mendeteksi adanya infeksi bakteri serius pada anak dengan demam serta mencari faktor prediktor terjadinya infeksi tersebut.Metode. Uji diagnostik untuk mengetahui validitas Skor RCPCH dalam mendeteksi adanya infeksi serius pada anak dengan demam dan kohort prospektif untuk mencari faktor prediktor. Baku emas adalah diagnosis akhir sesuai ICD-10. Seluruh pemeriksaan dilakukan secara buta (tersamar).Hasil. Didapatkan 260 subyek penelitian. Tujuh pasien rawat jalan tidak dapat dihubungi sehingga analisis dilakukan pada 253 subyek (97,3%). Laki-laki lebih banyak daripada perempuan dengan rasio 1,14: 1. Kelompok umur lebih banyak didapatkan pada kelompok > 36 bulan (51,4%). Diagnosis IBS didapatkan pada 28,9% subyek dengan diagnosis terbanyak pneumonia (19%). Skor RCPCH mempunyai sensitifitas 58,9%, spesifisitas 86,7%, nilai duga positif 64,2%, nilai duga negatif 83,8%, rasio kemungkinan positif 4,42, rasio kemungkinan negatif 0,47, post test probability 64,23%, area under ROC curve 72,8%. Batuk, sesak napas, mencret, kejang, umur 1-36 bulan, suhu tubuh ≥ 37,50 C, hipoksia, dan takipnea merupakan faktor prediktor terjadinya IBS.Simpulan. Skor RCPCH dapat digunakan untuk memprediksi infeksi bakteri serius pada anak umur 1 bulan–12 tahun. Batuk, sesak napas, mencret, kejang, umur 1-36 bulan, suhu tubuh ≥ 37,50 C, hipoksia, dan takipnea merupakan faktor prediktor terjadinya IBS.

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ABSTRACTBackground. The increase of child mortality in developing country, the high incidence of serious bacterial infection in children, the variety of risk factors of serious infections, current scoring model has not been tested in limited health care centre.Objective. To know the validity of of Royal College of Paediatrics and Child Health (RCPCH) Score to predict serious bacterial infection in children with fever and to find predictor factors of the serious infection.Method. Diagnostic study was used to find validity of RCPCH Score and cohort prospective study to find predictor factors of the serious infection. Gold standard was the latest diagnosis noted on medical record based on ICD-10. All tests were done blind.Results. There were 260 subjects. Seven patients of out-patient department could not be reached so analysis was done on 253 subjects (97.3%). There were more male than female with the ratio of 1.14:1. Age group of >36 months dominated the subject population (51.4%). Serious bacterial infection was found on 28.9% subject with the most diagnosis was pneumonia (19%). Sensitivity of SBI score was 58.9%, specificity was 86.7%, positive predictive value was 64.2%, negative predictive value was 83.8%, positive likelihood ratio was 4.42, negative likelihood ratio was 0.47, post test probability was 64,23%, and area under ROC curve was 72,8%. Cough, dyspnea, diarrhea, seizure, age of 1-36 month, body temperature ≥ 37.50 C, hypoxia, tachypnea were the risk factors for SBI.Conclusion. RCPCH Score can used to predict serious bacterial infection in children aged 1 month- 12 years. Cough, dyspnea, diarrhea, seizure, age of 1-36 months, body temperature ≥ 37.50 C, hypoxia, and tachypnea were the risk factors for SBI"