GSDCS Prediction Score of Vasudevan et al for Nosocomial Multi-Drug Resistant (MDR) Gram Negative Bacilli Infections in a Patient in the Intensive Care Unit (ICU)

Description

Vasudevan et al developed a score for identifying a patient in the intensive care unit (UC) with a multi-drug resistant Gram negative bacterial infection. This can help to select appropriate antibiotic therapy for the patient. The authors are from National University Health System in Singapore.

GSDCS stands for Gram (G) negative bacteria in last 6 months, surgery (S) during curing admission before onset, prior dialysis (D) with end stage renal disease, prior use of Carbapenem (C) in last 6 months, Stay (S) in the ICU for more than 5 days

Parameters:

(1) prior Gram negative bacteria infection within past 6 months

(2) prior administration of carbapenem within past 6 months

(3) surgery prior to resistant Gram negative bacilli infection

(4) dialysis with end-stage renal failure

(5) stay in ICU in days

Parameter	Finding	Points
prior Gram negative infection	no	0
	yes	1
prior carbapenem within past 6 months	no	0
	yes	1
surgery before infection	no	0
	yes	0.6
dialysis	no	0
	yes	0.7
stay in ICU	<= 5 days	0
	> 5 days	2
composite	history carpbapenem AND stay in ICU > 5 days	-1
	else	0

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 4.3

• The higher the score the greater the risk of multi-drug resistant infection.

Total Score	Risk	Prevalance Resistant Infection	Prevalence Resistant Bacteremia
<= 1.3	low	1.2%	0.2%
1.4 to 2.3	medium	6.3%	3%
>= 2.4	high	20%	10%

Performance:

• The area under the ROC curve was 0.77 for general prediction.

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GSDCS Prediction Score of Vasudevan et al for Nosocomial Multi-Drug Resistant (MDR) Gram Negative Bacilli Infections in a Patient in the Intensive Care Unit (ICU)

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