Risk scoring and bloodstream infections.
Risk-scoring systems are utilised in patients with bloodstream infections (BSI) to quantify disease-associated morbidity and mortality based on simple clinical or laboratory data usually obtained early in the course of illness. In order to reduce BSI-associated mortality, specific scores were elaborated to allow early diagnosis and prompt and appropriate antibiotic therapy. Risk scoring was also successfully derived and validated to identify patients at higher risk for antibiotic-resistant BSI, or colonisation, mainly due to methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. However, a major limitation of risk-scoring systems is the relevance to the local epidemiological environment and the difficulty in generalising results from a single study. Intelligence technology recently utilised scores to predict risks for specific pathogens causing BSI. An example of this innovation, the TREAT system, was able to significantly reduce mortality, length of hospitalisation and costs in patients with BSI. New randomised clinical trials are needed to study the efficacy of clinical scores in reducing BSI-associated morbidity and mortality.
Istituto Malattie Infettive, Università Cattolica S. Cuore, Rome, Italy. etaccone@bidmc.harvard.edu
Evelina
E
Tacconelli
Maria A
MA
Cataldo
Giulia
G
De Angelis
Roberto
R
Cauda
D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D017053:Infection Control / Q000379:methods; D016106:Methicillin Resistance; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D020713:Vancomycin Resistance