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Risk Factors of Cordonnier et al for Gram-Negative Bacterial Infection in a Patient with Febrile Neutropenia (Gram Negative Risk Index, GNRI)

Description

Cordonnier et al reported risk factors for Gram-negative bacterial infections in patients with febrile neutropenia. These can help identify patients at high risk for these infections who may benefit from more aggressive management. The authors are from multiple hospitals in France by members of the Club de Reflexion sur les Infections et Onco-Hematologie (CLIOH) Group


 

Patient selection: pediatric and adult patients with fever (>= 38°C) and neutropenia (absolute neutrophil count < 500 per µL)

 

Parameters:

(1) age

(2) beta-lactam antibiotic therapy

(3) chills

(4) urinary tract symptoms at inclusion

(5) gut decontamination

Parameters

Findings

Points

age

<= 45 years of age

0

 

> 45 years of age

1

beta-lactam antibiotic therapy

not recently

0

 

recently

1

chills

absent

0

 

present

1

urinary tract symptoms

absent

0

 

present

1

gut decontamination with colimycin and aminoglycosides

performed

0

 

not performed

1

 

total risk score = GNRI =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 5

• A score >= 3 is associated with a high risk for a Gram-negative bacterial infection.

 

Total Score

GN Infection Rate

0

0%

1

4%

2

13%

3

25%

4 or 5

100%

 


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