Utility of a blood culture time to positivity-incorporated scoring model in predicting vascular infections in adults with nontyphoid Salmonella bacteremia
Background: Vascular infections (VI) are potentially catastrophic complications of nontyphoid Salmonella (NTS). We aimed to develop a scoring model incorporating information from blood culture time to positivity (TTP-NTSVI) and compared the prediction capability for VI among adults with NTS bacterem...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-10-01
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| Series: | Journal of Microbiology, Immunology and Infection |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118218300458 |
| _version_ | 1811334286904655872 |
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| author | Jr-Jiun Lin Tzu-Hua Weng Wen-Pin Tseng Shang-Yu Chen Chia-Ming Fu Hui-Wen Lin Chun-Hsing Liao Tai-Fen Lee Po-Ren Hsueh Shey-Ying Chen |
| author_facet | Jr-Jiun Lin Tzu-Hua Weng Wen-Pin Tseng Shang-Yu Chen Chia-Ming Fu Hui-Wen Lin Chun-Hsing Liao Tai-Fen Lee Po-Ren Hsueh Shey-Ying Chen |
| author_sort | Jr-Jiun Lin |
| collection | DOAJ |
| description | Background: Vascular infections (VI) are potentially catastrophic complications of nontyphoid Salmonella (NTS). We aimed to develop a scoring model incorporating information from blood culture time to positivity (TTP-NTSVI) and compared the prediction capability for VI among adults with NTS bacteremia between TTP-NTSVI and a previously published score (Chen-NTSVI). Methods: This retrospective cohort study enrolled 217 adults with NTS bacteremia ≧ 50 years old. We developed a TTP-NTSVI score by multiple logistic regression modeling to identify independent predictors for imaging-confirmed VI and assigned a point value weighting by the corresponding natural logarithm of the odds ratio for each model predictor. Chen-NTSVI score includes hypertension, male sex, serogroup C1, coronary arterial disease (CAD) as positive predictors, and malignancy and immunosuppressive therapy as negative predictors. The prediction capability of the two scores was compared by area under the receiver operating characteristic curve (AUC). Results: The mean age was 68.3 ± 11.2 years-old. Serogroup D was the predominant isolate (155/217, 71.4%). Seventeen (7.8%) patients had VI. Four independent predictors for VI were identified: male sex (24.9 [2.59–239.60]; 6) (odds ratio [95% confidence interval]; assigned score point), peripheral arterial occlusive disease (9.41 [2.21–40.02]; 4), CAD (4.0 [1.16–13.86]; 3), and TTP <10 h (4.67 [1.42–15.39]; 3). Youden's index showed best cutoff value of ≧7 with 70.6% sensitivity and 82.5% specificity. TTP-NTSVI score had higher AUC than Chen-NTSVI (0.851 vs 0.741, P = 0.039). Conclusion: While the previously reported scoring model performed well, a TTP-incorporated scoring model was associated with improved capability in predicting NTSVI. Keywords: Nontyphoidal Salmonella, Blood culture, Time to positivity, Vascular infection, Prediction |
| first_indexed | 2024-04-13T17:06:33Z |
| format | Article |
| id | doaj.art-d609ef0fdf29490e85d943036d10d9f7 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-04-13T17:06:33Z |
| publishDate | 2018-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-d609ef0fdf29490e85d943036d10d9f72022-12-22T02:38:28ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822018-10-01515652658Utility of a blood culture time to positivity-incorporated scoring model in predicting vascular infections in adults with nontyphoid Salmonella bacteremiaJr-Jiun Lin0Tzu-Hua Weng1Wen-Pin Tseng2Shang-Yu Chen3Chia-Ming Fu4Hui-Wen Lin5Chun-Hsing Liao6Tai-Fen Lee7Po-Ren Hsueh8Shey-Ying Chen9Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, Far Eastern Memorial Hospital, Taipei, TaiwanDepartment of Internal Medicine, Far Eastern Memorial Hospital, Taipei, TaiwanDepartment of Laboratory Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Corresponding author. Department of Emergency Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No 7 Chung-Shan South Road, Taipei, Taiwan.Background: Vascular infections (VI) are potentially catastrophic complications of nontyphoid Salmonella (NTS). We aimed to develop a scoring model incorporating information from blood culture time to positivity (TTP-NTSVI) and compared the prediction capability for VI among adults with NTS bacteremia between TTP-NTSVI and a previously published score (Chen-NTSVI). Methods: This retrospective cohort study enrolled 217 adults with NTS bacteremia ≧ 50 years old. We developed a TTP-NTSVI score by multiple logistic regression modeling to identify independent predictors for imaging-confirmed VI and assigned a point value weighting by the corresponding natural logarithm of the odds ratio for each model predictor. Chen-NTSVI score includes hypertension, male sex, serogroup C1, coronary arterial disease (CAD) as positive predictors, and malignancy and immunosuppressive therapy as negative predictors. The prediction capability of the two scores was compared by area under the receiver operating characteristic curve (AUC). Results: The mean age was 68.3 ± 11.2 years-old. Serogroup D was the predominant isolate (155/217, 71.4%). Seventeen (7.8%) patients had VI. Four independent predictors for VI were identified: male sex (24.9 [2.59–239.60]; 6) (odds ratio [95% confidence interval]; assigned score point), peripheral arterial occlusive disease (9.41 [2.21–40.02]; 4), CAD (4.0 [1.16–13.86]; 3), and TTP <10 h (4.67 [1.42–15.39]; 3). Youden's index showed best cutoff value of ≧7 with 70.6% sensitivity and 82.5% specificity. TTP-NTSVI score had higher AUC than Chen-NTSVI (0.851 vs 0.741, P = 0.039). Conclusion: While the previously reported scoring model performed well, a TTP-incorporated scoring model was associated with improved capability in predicting NTSVI. Keywords: Nontyphoidal Salmonella, Blood culture, Time to positivity, Vascular infection, Predictionhttp://www.sciencedirect.com/science/article/pii/S1684118218300458 |
| spellingShingle | Jr-Jiun Lin Tzu-Hua Weng Wen-Pin Tseng Shang-Yu Chen Chia-Ming Fu Hui-Wen Lin Chun-Hsing Liao Tai-Fen Lee Po-Ren Hsueh Shey-Ying Chen Utility of a blood culture time to positivity-incorporated scoring model in predicting vascular infections in adults with nontyphoid Salmonella bacteremia Journal of Microbiology, Immunology and Infection |
| title | Utility of a blood culture time to positivity-incorporated scoring model in predicting vascular infections in adults with nontyphoid Salmonella bacteremia |
| title_full | Utility of a blood culture time to positivity-incorporated scoring model in predicting vascular infections in adults with nontyphoid Salmonella bacteremia |
| title_fullStr | Utility of a blood culture time to positivity-incorporated scoring model in predicting vascular infections in adults with nontyphoid Salmonella bacteremia |
| title_full_unstemmed | Utility of a blood culture time to positivity-incorporated scoring model in predicting vascular infections in adults with nontyphoid Salmonella bacteremia |
| title_short | Utility of a blood culture time to positivity-incorporated scoring model in predicting vascular infections in adults with nontyphoid Salmonella bacteremia |
| title_sort | utility of a blood culture time to positivity incorporated scoring model in predicting vascular infections in adults with nontyphoid salmonella bacteremia |
| url | http://www.sciencedirect.com/science/article/pii/S1684118218300458 |
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