Performance of Scoring Systems in Predicting Clinical Outcomes in Patients with Bacteremia of <i>Listeria monocytogenes</i>: A 9-Year Hospital-Based Study
Background: <i>Listeria monocytogenes</i> (LM) is a facultative anaerobe, Gram-positive bacillus which is widely distributed in nature, and can be separated from soil, water, and rotten vegetables. Immunocompetent people are less likely to suffer from LM infection or may only show gastro...
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MDPI AG
2021-10-01
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| Online Access: | https://www.mdpi.com/2079-7737/10/11/1073 |
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| author | Shang-Hsuan Huang Ming-Shun Hsieh Sung-Yuan Hu Shih-Che Huang Che-An Tsai Chiann-Yi Hsu Tzu-Chieh Lin Yi-Chen Lee Shu-Hui Liao |
| author_facet | Shang-Hsuan Huang Ming-Shun Hsieh Sung-Yuan Hu Shih-Che Huang Che-An Tsai Chiann-Yi Hsu Tzu-Chieh Lin Yi-Chen Lee Shu-Hui Liao |
| author_sort | Shang-Hsuan Huang |
| collection | DOAJ |
| description | Background: <i>Listeria monocytogenes</i> (LM) is a facultative anaerobe, Gram-positive bacillus which is widely distributed in nature, and can be separated from soil, water, and rotten vegetables. Immunocompetent people are less likely to suffer from LM infection or may only show gastrointestinal symptoms. However, immunocompromised elderly people, pregnant women, and newborns may develop life-threatening invasive infections. The mortality rate of LM infection is as high as 25–30%. The aim of this study is to investigate clinical scores of patients with bacteremia of LM confirmed by one or more blood cultures. We analyzed their demographics and laboratory findings in relation to their clinical outcomes. Materials and Methods: This was a hospital-based retrospective study on patients with bacteremia of LM. Data were collected from the electronic clinical database of Taichung Veterans General Hospital between January 2012 and December 2020. Bacteremia of LM was confirmed by at least one blood culture. Demographics, clinical characteristics, and laboratory data were collected for analysis. A variety of clinical scoring systems were used to predict the clinical outcome. Results: A total of 39 patients had confirmed bacteremia of LM. Among them, 1 neonatal patient was excluded. The remaining 38 patients were studied. They included 16 males (42.1%) and 22 females (57.9%), with a mean age of 59.9 ± 19.6 years. Their hospital stay averaged 23.3 ± 20.9 days. The in-hospital mortality rate was 36.8%. Mortality in Emergency Department Sepsis (MEDS) Score was 6.6 ± 4.0 for survivors and 12.4 ± 4.4 for non-survivors (P < 0.001). The National Early Warning Score (NEWS) was 3.9 ± 2.8 for survivors and 7.8 ± 3.1 for non-survivors (P = 0.001). Regarding the prediction of mortality risk, the AUC of ROC was 0.829 for MEDS and 0.815 for NEWS. Conclusions: MEDS and NEWS were both good predictors of the clinical outcome in LM bacteremic patients. In those with higher scores of MEDS (≥10) and NEWS (≥8), we recommended an early goal-directed therapy and appropriate antibiotic treatment as early as possible to reduce mortality. Further large-scale studies are required to gain a deeper understanding of this disease and to ensure patient safety. |
| first_indexed | 2024-03-10T05:42:06Z |
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| last_indexed | 2024-03-10T05:42:06Z |
| publishDate | 2021-10-01 |
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| spelling | doaj.art-523b3dce7f664d3caebea0876ec638152023-11-22T22:26:56ZengMDPI AGBiology2079-77372021-10-011011107310.3390/biology10111073Performance of Scoring Systems in Predicting Clinical Outcomes in Patients with Bacteremia of <i>Listeria monocytogenes</i>: A 9-Year Hospital-Based StudyShang-Hsuan Huang0Ming-Shun Hsieh1Sung-Yuan Hu2Shih-Che Huang3Che-An Tsai4Chiann-Yi Hsu5Tzu-Chieh Lin6Yi-Chen Lee7Shu-Hui Liao8Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, TaiwanDepartment of Emergency Medicine, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan 330, TaiwanDepartment of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, TaiwanSchool of Medicine, Chung Shan Medical University, Taichung 40201, TaiwanDivision of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, TaiwanBiostatistics Task Force, Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, TaiwanDepartment of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, TaiwanDepartment of Emergency Medicine, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan 330, TaiwanDepartment of Pathology and Laboratory, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan 330, TaiwanBackground: <i>Listeria monocytogenes</i> (LM) is a facultative anaerobe, Gram-positive bacillus which is widely distributed in nature, and can be separated from soil, water, and rotten vegetables. Immunocompetent people are less likely to suffer from LM infection or may only show gastrointestinal symptoms. However, immunocompromised elderly people, pregnant women, and newborns may develop life-threatening invasive infections. The mortality rate of LM infection is as high as 25–30%. The aim of this study is to investigate clinical scores of patients with bacteremia of LM confirmed by one or more blood cultures. We analyzed their demographics and laboratory findings in relation to their clinical outcomes. Materials and Methods: This was a hospital-based retrospective study on patients with bacteremia of LM. Data were collected from the electronic clinical database of Taichung Veterans General Hospital between January 2012 and December 2020. Bacteremia of LM was confirmed by at least one blood culture. Demographics, clinical characteristics, and laboratory data were collected for analysis. A variety of clinical scoring systems were used to predict the clinical outcome. Results: A total of 39 patients had confirmed bacteremia of LM. Among them, 1 neonatal patient was excluded. The remaining 38 patients were studied. They included 16 males (42.1%) and 22 females (57.9%), with a mean age of 59.9 ± 19.6 years. Their hospital stay averaged 23.3 ± 20.9 days. The in-hospital mortality rate was 36.8%. Mortality in Emergency Department Sepsis (MEDS) Score was 6.6 ± 4.0 for survivors and 12.4 ± 4.4 for non-survivors (P < 0.001). The National Early Warning Score (NEWS) was 3.9 ± 2.8 for survivors and 7.8 ± 3.1 for non-survivors (P = 0.001). Regarding the prediction of mortality risk, the AUC of ROC was 0.829 for MEDS and 0.815 for NEWS. Conclusions: MEDS and NEWS were both good predictors of the clinical outcome in LM bacteremic patients. In those with higher scores of MEDS (≥10) and NEWS (≥8), we recommended an early goal-directed therapy and appropriate antibiotic treatment as early as possible to reduce mortality. Further large-scale studies are required to gain a deeper understanding of this disease and to ensure patient safety.https://www.mdpi.com/2079-7737/10/11/1073area under the curve (AUC)bacteremia<i>Listeria monocytogenes</i> (LM)mortality in emergency department sepsis (MEDS) scorenational early warning score (NEWS)scoring systems |
| spellingShingle | Shang-Hsuan Huang Ming-Shun Hsieh Sung-Yuan Hu Shih-Che Huang Che-An Tsai Chiann-Yi Hsu Tzu-Chieh Lin Yi-Chen Lee Shu-Hui Liao Performance of Scoring Systems in Predicting Clinical Outcomes in Patients with Bacteremia of <i>Listeria monocytogenes</i>: A 9-Year Hospital-Based Study Biology area under the curve (AUC) bacteremia <i>Listeria monocytogenes</i> (LM) mortality in emergency department sepsis (MEDS) score national early warning score (NEWS) scoring systems |
| title | Performance of Scoring Systems in Predicting Clinical Outcomes in Patients with Bacteremia of <i>Listeria monocytogenes</i>: A 9-Year Hospital-Based Study |
| title_full | Performance of Scoring Systems in Predicting Clinical Outcomes in Patients with Bacteremia of <i>Listeria monocytogenes</i>: A 9-Year Hospital-Based Study |
| title_fullStr | Performance of Scoring Systems in Predicting Clinical Outcomes in Patients with Bacteremia of <i>Listeria monocytogenes</i>: A 9-Year Hospital-Based Study |
| title_full_unstemmed | Performance of Scoring Systems in Predicting Clinical Outcomes in Patients with Bacteremia of <i>Listeria monocytogenes</i>: A 9-Year Hospital-Based Study |
| title_short | Performance of Scoring Systems in Predicting Clinical Outcomes in Patients with Bacteremia of <i>Listeria monocytogenes</i>: A 9-Year Hospital-Based Study |
| title_sort | performance of scoring systems in predicting clinical outcomes in patients with bacteremia of i listeria monocytogenes i a 9 year hospital based study |
| topic | area under the curve (AUC) bacteremia <i>Listeria monocytogenes</i> (LM) mortality in emergency department sepsis (MEDS) score national early warning score (NEWS) scoring systems |
| url | https://www.mdpi.com/2079-7737/10/11/1073 |
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