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Description

Mussa et al reported a score for predicting a biliary tract infection with bacteremia due to Enterococcus faecalis or Enterococcus faecium. The authors are from multiple institutions in Italy and Spain.


Patient selection: biliary tract infection with bacteremia

 

Parameters:

(1) cholangiocarcinoma

(2) nosocomial (acquired in hospital)

(3) history of carbapenem therapy in previous month

(4) biliary prosthesis

(5) chronic kidney disease stage 4 or 5

 

Parameter

Finding

Points

cholangiocarcinoma

no

0

 

yes

7

nosocomial

no

0

 

yes

6

carbapenem therapy

no

0

 

yes

5

biliary prosthesis

no

0

 

yes

4

CKD stage 4 or 5

no

0

 

yes

2

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 24

• A score >= 3 had a sensitivity of 0.73 and specificity of 0.68 for infection with Enterococcus faecalis or faecium, which gave the maximum Youden index.

• A score <= 6 had a negative predictive value of 0.95-0.96. This group had a rate of infection with Enterococcus faecalis or faecium of 16 to 20%, with the majority of cases.

 

Performance:

• The area under the ROC curve is 0.74


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