Hernandez-Jimenez et al reported a score for predicting that the Pseudomonas aerguinosa infecting a patient is multi-drug resistant (MDR). This information can help guide empirical antibiotic therapy until susceptibility test results are available. The authors are from Sanitaria Hospital, Universidad Complutense, Instituto de Salud Carlos III and Merck, Sharpe & Dohme in Madrid.
Patient selection: Pseudomonas aeruginosa infection prior to availability of antibiotic susceptibility testing
Parameters:
(1) isolation of multi-drug resistant Pseudomonas aeruginosa in the past 3 months
(2) history of antibiotic therapy in the past 3 months
(3) septic shock at diagnosis
(4) hospital-acquired infection
Parameter
Finding
Points
isolation of MDR Pseudomonas in past 3 months
no
0
yes
11
recent antibiotic therapy
no
0
yes
3
septic shock at diagnosis
no
0
yes
2
hospital-acquired infection
no
0
yes
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• A score >= 5 is considered positive.
Total Score
Probability MDR Pseudomonas
0
11%
2
20%
3 to 5
27-45%
7
56%
11
59%
13 to 16
75-87%
18
93%
Performance:
• The area under the ROC curve is 0.76.
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