A Simple Scoring Algorithm Predicting Vascular Infections in Adults With Nontyphoid Salmonella Bacteremia

• Published in: Clinical Infectious Diseases
• Main Authors: Chen, Po-Lin, Lee, Ching-Chi, Li, Chung-Yi, Chang, Chia-Ming, Lee, Hsin-Chun, Lee, Nan-Yao, Wu, Chi-Jung, Shih, Hsin-I, Tang, Hung-Jen, Ko, Wen-Chien, Wu, Chi-Jung�
• Other Authors: 保健營養系
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford Univ Press Inc 2012
• Subjects: Abdominal Aortic-Aneurysms; Extraintestinal Focal Infections; Enterica Serotype Choleraesuis; Risk-Factors; Endovascular Infection; Mycotic-Aneurysms; Management; Resistance; Tromso
• Online Access: https://ir.cnu.edu.tw/handle/310902800/27611; https://doi.org/10.1093/cid/cis381; https://ir.cnu.edu.tw/bitstream/310902800/27611/-1/index.html

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.