title: Identification of concurrent bacterial infection in adult patients with dengue.
abstract: We aim to construct a diagnostic model for bacterial coinfection in dengue patients (Dengue Dual Infection Score [DDIS]); 2,065 adult dengue patients (mean age = 41.9 ± 17.2 years, 58.4% male, 83 patients with bacterial coinfection) seen at a university hospital from January of 2005 to February of 2010 were studied. The DDIS was created by assigning one point to each of five risk factors for bacterial coinfection: pulse rate ≥ 90 beats/minute, total white cell count ≥ 6 × 10(9)/L, hematocrit < 40%, serum sodium < 135 mmol/L, and serum urea ≥ 5 mmol/L. The DDIS identified bacterial coinfection (derivation set area under the curve = 0.793, 95% confidence interval = 0.732-0.854; validation set area under the curve = 0.761, 95% confidence interval = 0.637-0.886). A DDIS of ≥ 4 had a specificity of 94.4%, whereas a DDIS of ≥ 1 had a sensitivity of 94.4% for bacterial coinfection. The DDIS can help to select dengue patients for early bacterial cultures and empirical antibiotics.
authors: University Medicine Cluster, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors: Kay C
authors: KC
authors: See
authors: Jason
authors: J
authors: Phua
authors: Hwee S
authors: HS
authors: Yip
authors: Leong L
authors: LL
authors: Yeo
authors: Tow K
authors: TK
authors: Lim
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000150:complications*; D060085:Coinfection / Q000175:diagnosis*; D003715:Dengue / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors
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