Scores of Nodaras et al for Predicting the Probable Pathogen Causing Acute Bacterial Skin and Skin Structure Infection (ABSSSI) in Greece

Patient selection: acute bacterial infection of skin or skin structures (ABSSSI), age >= 18 years

Parameters:

(1) hospitalization in the past 90 days

(2) atrial fibrillation

(3) residence location

(4) ischemic stroke

(5) infection of the lumbar area

(6) recent quinolone intake

(7) cutaneous ulcer

(8) peptic ulcer

(9) solid malignancy

score for MRSA =

= (points for hospitalization + (points for atrial fibrillation) + (points for residence) + (points for ischemic stroke)

score for infection with both Gram(+) and Gram(-) =

= (points for infection of lumbar area) + (points for quinolone intake) + (points for residence) + (points for ischemic stroke)

score for Gram(-) =

= (points for ulcer) + (points for peptic ulcer) + (points for solid malignancy)

Interpretation:

• minimum score for MRSA: -4

• maximum score for MRSA: 23

• minimum score for both Gram(+)/Gram(-): -16

• maximum score for both Gram(+)/Gram(-): 22

• minimum score for Gram (-): 0

• maximum score for Gram(-): 33

• An MRSA score >= 12 had a positive predictive value of 50%. An MRSA score < 12 had a negative predictive value of 74% for MRSA.

• A Gram(+)/Gram(-) score >= 8 had a positive predictive value of 43%. A Gram(+)/Gram(-) score < 8 had a negative predictive value of 80% for a mixed Gram(+)/Gram(-) infection.

• A Gram(-) score >= 21had a positive predictive value of 38%. A Gram(-) score < 21 had a negative predictive value of 91% for a Gram(-) infection.

• The results of the scores may be suitable for initial antibiotic selection, but the final diagnosis should be based on culture findings.