title: Intensive Care Infection Score--A new approach to distinguish between infectious and noninfectious processes in intensive care and medicosurgical patients.
abstract: OBJECTIVE
  Clinicians regularly encounter substantial time delays in diagnosing sepsis and administering appropriate antibiotic treatment. This study investigated the ability of the Intensive Care Infection Score (ICIS) to distinguish between infectious and noninfectious processes, and to assess the justified commencement of antibiotic therapy retrospectively, in line with hospital actual best practice and applied laboratory parameters.
  
  
  METHODS
  Intensive-care unit (ICU) patients were enrolled in this retrospective, observational study. Clinical data and laboratory parameters were determined daily. The cohort was divided into infected and noninfected patient groups.
  
  
  RESULTS
  Out of 172 ICU patients, including 72 postoperative patients, the predictive value for infection throughout the first 5 days in 'all patients' and the 'postoperative patient' group was highest for ICIS. An ICIS cut-off value of three could predict infection in postoperative patients with 82.9% sensitivity and 75.1% specificity. ICIS showed the lowest rate of potentially 'falsely encouraged' and 'discouraged' antibiotic therapies for noninfected and for septic postoperative patients, respectively, compared with C-reactive protein, procalcitonin and white blood cell levels.
  
  
  CONCLUSIONS
  In the ICU, particularly for postoperative patients, ICIS is a reliable marker for the timely identification of infection. ICIS may qualify as a new decision support tool for antibiotic therapy, when interpreted within the clinical context.
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, University Medical Centre, Berlin, Germany.
authors: Karin
authors: K
authors: Weimann
authors: Department of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany Labor Berlin - Charité Vivantes Services, Berlin, Germany mathias.zimmermann@charite.de.
authors: Mathias
authors: M
authors: Zimmermann
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, University Medical Centre, Berlin, Germany.
authors: Claudia D
authors: CD
authors: Spies
authors: University Medical Centre, Berlin, Germany and SOSTANA GmbH, Berlin, Germany.
authors: Klaus-Dieter
authors: KD
authors: Wernecke
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, University Medical Centre, Berlin, Germany.
authors: Oldrich
authors: O
authors: Vicherek
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, University Medical Centre, Berlin, Germany.
authors: Irit
authors: I
authors: Nachtigall
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, University Medical Centre, Berlin, Germany.
authors: Sascha
authors: S
authors: Tafelski
authors: Department of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany Labor Berlin - Charité Vivantes Services, Berlin, Germany.
authors: Andreas
authors: A
authors: Weimann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers; D003422:Critical Care; D003937:Diagnosis, Differential; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers
keywords: Intensive care unit (ICU); antibiotic therapy guidance; infection score; postoperative patients; systemic inflammatory response syndrome (SIRS)