RT Journal Article
T1 Development and validation of the INCREMENT-ESBL predictive score for mortality in patients with bloodstream infections due to extended-spectrum-β-lactamase-producing Enterobacteriaceae.
A1 Palacios-Baena, Zaira Raquel
A1 Gutierrez-Gutierrez, Belen
A1 De Cueto, Marina
A1 Viale, Pierluigi
A1 Venditti, Mario
A1 Hernandez-Torres, Alicia
A1 Oliver, Antonio
A1 Martinez-Martinez, Luis
A1 Calbo, Esther
A1 Pintado, Vicente
A1 Gasch, Oriol
A1 Almirante, Benito
A1 Antonio Lepe, Jose
A1 Pitout, Johann
A1 Akova, Murat
A1 Peña-Miralles, Carmen
A1 Schwaber, Mitchell J
A1 Tumbarello, Mario
A1 Tacconelli, Evelina
A1 Origüen, Julia
A1 Prim, Nuria
A1 Bou, German
A1 Giamarellou, Helen
A1 Bermejo, Joaquin
A1 Hamprecht, Axel
A1 Perez, Federico
A1 Almela, Manuel
A1 Lowman, Warren
A1 Hsueh, Po-Ren
A1 Navarro-San Francisco, Carolina
A1 Torre-Cisneros, Julian
A1 Carmeli, Yehuda
A1 Bonomo, Robert A
A1 Paterson, David L
A1 Pascual, Alvaro
A1 Rodriguez-Baño, Jesus
K1 Bacteremia
K1 Enterobacteriaceae
K1 Klebsiella
K1 Logistic models
AB Bloodstream infections (BSIs) due to ESBL-producing Enterobacteriaceae (ESBL-E) are frequent yet outcome prediction rules for clinical use have not been developed. The objective was to define and validate a predictive risk score for 30 day mortality. A multinational retrospective cohort study including consecutive episodes of BSI due to ESBL-E was performed; cases were randomly assigned to a derivation cohort (DC) or a validation cohort (VC). The main outcome variable was all-cause 30 day mortality. A predictive score was developed using logistic regression coefficients for the DC, then tested in the VC. The DC and VC included 622 and 328 episodes, respectively. The final multivariate logistic regression model for mortality in the DC included age >50 years (OR = 2.63; 95% CI: 1.18-5.85; 3 points), infection due to Klebsiella spp. (OR = 2.08; 95% CI: 1.21-3.58; 2 points), source other than urinary tract (OR = 3.6; 95% CI: 2.02-6.44; 3 points), fatal underlying disease (OR = 3.91; 95% CI: 2.24-6.80; 4 points), Pitt score >3 (OR = 3.04; 95 CI: 1.69-5.47; 3 points), severe sepsis or septic shock at presentation (OR = 4.8; 95% CI: 2.72-8.46; 4 points) and inappropriate early targeted therapy (OR = 2.47; 95% CI: 1.58-4.63; 2 points). The score showed an area under the receiver operating curve (AUROC) of 0.85 in the DC and 0.82 in the VC. Mortality rates for patients with scores of 50 years (OR = 2.63; 95% CI: 1.18-5.85; 3 points), infection due to Klebsiella spp. (OR = 2.08; 95% CI: 1.21-3.58; 2 points), source other than urinary tract (OR = 3.6; 95% CI: 2.02-6.44; 3 points), fatal underlying disease (OR = 3.91; 95% CI: 2.24-6.80; 4 points), Pitt score >3 (OR = 3.04; 95 CI: 1.69-5.47; 3 points), severe sepsis or septic shock at presentation (OR = 4.8; 95% CI: 2.72-8.46; 4 points) and inappropriate early targeted therapy (OR = 2.47; 95% CI: 1.58-4.63; 2 points). The score showed an area under the receiver operating curve (AUROC) of 0.85 in the DC and 0.82 in the VC. Mortality rates for patients with scores of 3 (OR = 3.04; 95 CI: 1.69-5.47; 3 points), severe sepsis or septic shock at presentation (OR = 4.8; 95% CI: 2.72-8.46; 4 points) and inappropriate early targeted therapy (OR = 2.47; 95% CI: 1.58-4.63; 2 points). The score showed an area under the receiver operating curve (AUROC) of 0.85 in the DC and 0.82 in the VC. Mortality rates for patients with scores of  We developed and validated an easy-to-collect predictive scoring model for all-cause 30 day mortality useful for identifying patients at high and low risk of mortality.
PB Oxford University Press
YR 2016
FD 2016-11-02
LK http://hdl.handle.net/10668/10751
UL http://hdl.handle.net/10668/10751
LA en
NO Palacios-Baena ZR, Gutiérrez-Gutiérrez B, De Cueto M, Viale P, Venditti M, Hernández-Torres A, et al. Development and validation of the INCREMENT-ESBL predictive score for mortality in patients with bloodstream infections due to extended-spectrum-β-lactamase-producing Enterobacteriaceae. J Antimicrob Chemother. 2017 Mar 1;72(3):906-913
DS RISalud
RD Apr 5, 2025