Patient selection: adult with complicated urinary tract infection with Gram-negative pathogens
Gram-negative pathogens: Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, Enterobacteriaceae
Carbapenem resistance: intermediate or complete resistance to imipenem, meropenem, ertapenem, doripenem
Parameters:
(1) history of weight loss
(2) admission from an extended-care facility
(3) early mechanical ventilation
(4) age in years
(5) sex
(6) catheter-associated UTI
(7) prior antibiotic therapy
(8) prior infection with a carbapenem-resistant organism
|
Parameter
|
Finding
|
Points
|
|
history of weight loss
|
no
|
0
|
|
|
yes
|
1
|
|
admission from ECF
|
no
|
0
|
|
|
yes
|
1
|
|
early mechanical ventilation
|
no
|
0
|
|
|
yes
|
1
|
|
age
|
< 50 years
|
2
|
|
|
>= 50 years
|
0
|
|
sex
|
male
|
3
|
|
|
female
|
0
|
|
catheter-associated UTI
|
no
|
0
|
|
|
yes
|
4
|
|
prior antibiotic therapy
|
no
|
0
|
|
|
yes
|
4
|
|
prior infection with carbapenem resistant organism
|
no
|
0
|
|
|
yes
|
8
|
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• The higher the score the greater the risk of carbapenem resistance.
|
Score
|
Percent Resistant
|
|
0 to 2
|
1%
|
|
3
|
2-3%
|
|
4 or 5
|
4-5.5%
|
|
6 or 7
|
6%
|
|
8 or 9
|
7-8.5%
|
|
>= 10
|
14-15%
|
Performance:
• The area under ROC curve is 0.72.
