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

Po-Lin Chen, Ching Chi Lee, Chung-Yi Li, Chia-Ming Chang, Hsin Chun Lee, Nan-Yao Lee, Chi Jung Wu, Hsin-I Shih, Hung Jen Tang, Wen-Chien Ko

Research output: Contribution to journalArticle

15 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)194-200
Number of pages7
JournalClinical Infectious Diseases
Volume55
Issue number2
DOIs
Publication statusPublished - 2012 Jul 15

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Bacteremia
Salmonella
Blood Vessels
Infection
Salmonella Infections
Immunosuppressive Agents
Taiwan
ROC Curve
Area Under Curve
Cost-Benefit Analysis
Coronary Disease
Logistic Models
Confidence Intervals
Hypertension
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

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title = "A simple scoring algorithm predicting vascular infections in adults with nontyphoid salmonella bacteremia",
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.",
author = "Po-Lin Chen and Lee, {Ching Chi} and Chung-Yi Li and Chia-Ming Chang and Lee, {Hsin Chun} and Nan-Yao Lee and Wu, {Chi Jung} and Hsin-I Shih and Tang, {Hung Jen} and Wen-Chien Ko",
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A simple scoring algorithm predicting vascular infections in adults with nontyphoid salmonella bacteremia. / 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.

In: Clinical Infectious Diseases, Vol. 55, No. 2, 15.07.2012, p. 194-200.

Research output: Contribution to journalArticle

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AU - Chen, Po-Lin

AU - Lee, Ching Chi

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AU - Chang, Chia-Ming

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AU - Lee, Nan-Yao

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AU - Shih, Hsin-I

AU - Tang, Hung Jen

AU - Ko, Wen-Chien

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N2 - 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.

AB - 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.

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