Methods: A retrospective chart review based case-control analysis was conducted on adult patients hospitalized at Assaf Harofeh Medical Center (Israel), from which blood cultures were obtained due to suspected nosocomial sepsis, between 01/01/13 – 28/02/13. All patients were included regardless of their culture results. Validation of the XDR nosocomial sepsis scores were executed by using conventional methodologies and ROC curve analyses.
Results: Overall, 406 patients with nosocomial sepsis were enrolled: 34 patients had XDR confirmed nosocomial sepsis (cases) and 372 had non-XDR nosocomial sepsis (controls). The "Vitkon score" had a sensitivity of 26%, and the ROC AUC of the "Michaeli score" was 0.55. In univariable analysis, patients with XDR sepsis had increased severity of acute illness indices (p<0.001), suffered from substantial DAAT (p=0.02), and had significant worse clinical outcomes, with longer hospital stays (p=0.005) and higher mortality (p<0.001).
Conclusion: The study aim was to validate previously developed scores that differentiate MDR from XDR infection, on a cohort of patients with nosocomial sepsis. Yet, as reflected by this study, both scores' performances were inadequate. Larger prospective multicenter studies are needed, in order to develop and later-on validate such a score, which could improve the outcomes of patients with nosocomial XDR infections and contribute to stewardship efforts.
R. Zaidenstein, None
M. Dadon, None
C. Daniel, None
D. Marchaim, None
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