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Clin Infect Dis. 2012 Jul;55(2):194-200. doi: 10.1093/cid/cis381. Epub 2012 Apr 4.

A simple scoring algorithm predicting vascular infections in adults with nontyphoid Salmonella bacteremia.

Author information

1
Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.

Erratum in

  • Clin Infect Dis. 2012 Nov;55(9):1277.

Abstract

BACKGROUND:

Nontyphoid Salmonella (NTS) can cause fatal vascular infections. This study aims to establish a predictive scoring algorithm to identify adults aged ≥ 50 years with NTS bacteremia who are at risk for vascular infections.

METHODS:

There were 358 adults aged ≥ 50 years with NTS bacteremia at 2 medical centers in southern Taiwan included in this study. Multiple logistic regression was used to identify risk factors for imaging-documented vascular infections. The prediction capability of the proposed scoring algorithm was indicated by a receiver operating characteristic curve and measures of sensitivity and specificity.

RESULTS:

Sixty patients (16.8%) with vascular infections were noted. The 4 risk factors significantly associated with vascular infections-male sex, hypertension, coronary arterial disease, and serogroup C1 infections-were each assigned +1 point to form the NTS vascular infection (NTSVI) score. In contrast, malignancy and immunosuppressive therapy were each assigned -1 point, owing to their negative associations with vascular infections. Based on the proposed NTSVI scoring, the prevalence of vascular infections in patients with ≤ 0, 1, 2, 3, or 4 points was 2.2% (3 of 138 patients), 10.6% (13 of 123 patients), 39.4% (26 of 66 patients), 55.2% (16 of 29 patients), and 100% (2 of 2 patients), respectively (P< .0001). The scoring algorithm shows an area under the curve of 0.83 (95% confidence interval, .78-.89; P < .0001). A cutoff value of +1 represents a high sensitivity (95.0%) and an acceptable specificity (45.3%).

CONCLUSIONS:

This simple scoring algorithm can be used to identify patients with NTS bacteremia with a high risk of vascular infections. The cost-effectiveness of this algorithm should be further studied.

Comment in

PMID:
22491337
DOI:
10.1093/cid/cis381
[Indexed for MEDLINE]

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