Teysseyre et al reported the CarbaSCORE for evaluating a patient in the ICU with a bloodstream infection or pneumonia. This can help to identify an infection caused by bacteria requiring carbapenem treatment. The authors are from multiple institutions in France.
Patient selection: patient with ICU with bloodstream infection or pneumonia
Outcome: need for carbapenem treatment
Parameters:
(1) bloodstream infection
(2) chronic hemodialysis
(3) travel abroad in the past 6 months
(4) MDR colonization
(5) use of a beta-lactam class >= 3 (Weiss et al) in the 3 months prior to infection
Parameter
Finding
Points
bloodstream infection
no
0
yes
2
chronic hemodialysis
no
0
yes
4
travel abroad
no
0
yes
5
MDR colonization or use of beta-lactam
both
6
either
6
neither
0
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 17
• A score >= 6 had a sensitivity of 0.96 and specificity of 0.39.
• A score >= 7 had the maximum Youden score (sensitivity 0.81 and specificity 0.69).
• A score >= 9 had a sensitivity of 0.48 and specificity of 0.91.
Performance:
• The area under the ROC score is 0.81.
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