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Tytuł pozycji:

Development and validation of a bedside risk score for MRSA among patients hospitalized with complicated skin and skin structure infections

Tytuł :
Development and validation of a bedside risk score for MRSA among patients hospitalized with complicated skin and skin structure infections
Autorzy :
Zilberberg Marya D
Chaudhari Paresh
Nathanson Brian H
Campbell Rebecca S
Emons Matthew F
Fiske Suzanne
Hays Harlen D
Shorr Andrew F
Pokaż więcej
Temat :
Skin infection
Prediction rule
Clinical decision
MRSA
Hospitalization
Infectious and parasitic diseases
RC109-216
Źródło :
BMC Infectious Diseases, Vol 12, Iss 1, p 154 (2012)
Wydawca :
BMC, 2012.
Rok publikacji :
2012
Typ dokumentu :
article
Opis pliku :
electronic resource
Język :
English
ISSN :
1471-2334
Relacje :
http://www.biomedcentral.com/1471-2334/12/154; https://doaj.org/toc/1471-2334
DOI :
10.1186/1471-2334-12-154
Dostęp URL :
https://doaj.org/article/0c0deb6aa2374c85bdc7b1afaab81266
Numer akcesji :
edsdoj.0c0deb6aa2374c85bdc7b1afaab81266
Czasopismo naukowe
Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of complicated skin and skin structure infections (cSSSI). Patients with MRSA require different empiric treatment than those with non-MRSA infections, yet no accurate tools exist to aid in stratifying the risk for a MRSA cSSSI. We sought to develop a simple bedside decision rule to tailor empiric coverage more accurately. Methods We conducted a large multicenter (N=62 hospitals) retrospective cohort study in a US-based database between April 2005 and March 2009. All adult initial admissions with ICD-9-CM codes specific to cSSSI were included. Patients admitted with MRSA vs. non-MRSA were compared with regard to baseline demographic, clinical and hospital characteristics. We developed and validated a model to predict the risk of MRSA, and compared its performance via sensitivity, specificity and other classification statistics to the healthcare-associated (HCA) infection risk factors. Results Of the 7,183 patients with cSSSI, 2,387 (33.2%) had MRSA. Factors discriminating MRSA from non-MRSA were age, African-American race, no evidence of diabetes mellitus, cancer or renal dysfunction, and prior history of cardiac dysrhythmia. The score ranging from 0 to 8 points exhibited a consistent dose–response relationship. A MRSA score of 5 or higher was superior to the HCA classification in all characteristics, while that of 4 or higher was superior on all metrics except specificity. Conclusions MRSA is present in 1/3 of all hospitalized cSSSI. A simple bedside risk score can help discriminate the risk for MRSA vs. other pathogens with improved accuracy compared to the HCA definition.

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