Webb et al reported a score for predicted bloodstream infection (BSI) with vancomycin-resistant enterococci (VRE) in patients undergoing leukemia induction or hematopoietic stem-cell transplantation. The authors are from Intermountain Healthcare in Salt Lake City.
Patient selection: leukemia induction or hematopoietic stem cell transplantation (HSCT)
Parameters:
(1) VRE colonization
(2) severe neutropenia (absolute neutrophil count < 100 per µL)
(3) gastrointestinal disruption
(4) renal insufficiency
(5) antibiotic therapy against anaerobic bacteria
(6) carbapenem use
(7) aminoglycoside use
(8) cephalosporin use
Parameter
Finding
Points
VRE colonization
no
0
yes
1
severe neutropenia
no
0
yes
1
GI tract disruption
no
0
yes
1
renal insufficiency
no
0
yes
1
therapy against anaerobes
no
0
yes
1
carbapenem use
no
0
yes
1
aminoglycoside use
no
0
yes
1
cephalosporin use
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• A score >= 5 is associated with a 3.7-fold increase in VRE BSI (high risk).
Performance:
• The area under the ROC curve is 0.84.
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