The online version of this article (https://doi.org/10.1186/s12879-017-2919-2) contains supplementary material, which is available to authorized users.
Methicillin-resistant Staphylococcus aureus (MRSA) infections continue to be a leading problem in health care facilities worldwide.
This single-center retrospective cohort study consisted of a derivation phase and a validation phase. The derivation phase included all patients admitted to Osaka University Hospital between May 2010 and April 2011. We proposed a provisional available, bed-sided, comprehensive (ABC) score, and evaluated its accuracy using the clinical diagnosis as a reference. We subsequently revised ABC scores based on k coefficient scores of each variable; this revision was validated by applying it to another patient population.
A total of 172 patients and 154 cases were enrolled in the derivation and validation studies, respectively. The revised ABC score consisted of four simple variables: type of clinical specimen (1 to 3 points), Gram-staining result (1 point), presence of local inflammation (2 points), and a systemic inflammatory response (2 points). A revised score of ≥5 points was sensitive (93.8%) and specific (90.6%), and the area under the receiver-operating curve was 0.969 (95% CI; 0.957–1).
We developed a simple and comprehensive scoring system for diagnosis of nosocomial MRSA infections; this system is applicable in a wide variety of situations.
Additional file 1: The provisional ABC score. (PDF 52 kb)12879_2017_2919_MOESM1_ESM.pdf
Additional file 2: Comparison of the two patient cohorts. (PDF 149 kb)12879_2017_2919_MOESM2_ESM.pdf
Additional file 3: Clinical diagnosis associated with each specimen in the derivation cohort. (PDF 48 kb)12879_2017_2919_MOESM3_ESM.pdf
Additional file 4: Evaluation of each subjects with scores applied. (PDF 100 kb)12879_2017_2919_MOESM4_ESM.pdf
Additional file 5: Receiver operating characteristic curves for the provisional score of the derivation phase. (PDF 399 kb)12879_2017_2919_MOESM5_ESM.pdf
Hidron AI, Edwards JR, Patel J, Horan TC, Sievert DM, Pollock DA, Fridkin SK, National Healthcare Safety Network Team; Participating National Healthcare Safety Network Facilities. NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol. 2008;29(11):996–1011. CrossRefPubMed
Kallen AJ, Mu Y, Bulens S, Reingold A, Petit S, Gershman K, Ray SM, Harrison LH, Lynfield R, Dumyati G, Townes JM, Schaffner W, Patel PR, Fridkin SK. Active Bacterial Core surveillance (ABCs) MRSA investigators of the emerging infections program. Health care-associated invasive MRSA infections, 2005-2008. JAMA. 2010;304(6):641–8. CrossRefPubMed
Klevens RM, Morrison MA, Nadle J, Petit S, Gershman K, Ray S, Harrison LH, Lynfield R, Dumyati G, Townes JM, Craig AS, Zell ER, Fosheim GE, McDougal LK, Carey RB. Fridkin SK; active bacterial Core surveillance (ABCs) MRSA investigators. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA. 2007;298(15):1763–71. CrossRefPubMed
Engemann JJ, Carmeli Y, Cosgrove SE, Fowler VG, Bronstein MZ, Trivette SL, Briggs JP, Sexton DJ, Kaye KS. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis. 2003;36(5):592–8. CrossRefPubMed
Gasch O, Ayats J, Angeles Dominguez M, Tubau F, Liñares J, Peña C, Grau I, Pallarés R, Gudiol F, Ariza J, Pujol M. Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection: secular trends over 19 years at a university hospital. Medicine (Baltimore). 2011;90(5):319–27. CrossRef
Sader HS, Fey PD, Limaye AP, Madinger N, Pankey G, Rahal J, Rybak MJ, Snydman DR, Steed LL, Waites K, Jones RN. Evaluation of vancomycin and daptomycin potency trends (MIC creep) against methicillin-resistant Staphylococcus aureus isolates collected in nine U.S. medical centers from 2002 to 2006. Antimicrob Agents Chemother. 2009;53(10):4127–32. CrossRefPubMedPubMedCentral
Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, Kaplan SL, Karchmer AW, Levine DP, Murray BE, Rybak MJ, Talan DA, Chambers HF. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children: executive summary. Clin Infect Dis. 2011;52(3):285–92. CrossRefPubMed
Chen SY, Chiang WC, Ma MH, Hsueh PR, Chang SC, Fang CC, Chen SC, Chen WJ, Chie WC, Lai MS. Predicting methicillin resistance among community-onset Staphylococcus aureus bacteremia patients with prior healthcare-associated exposure. Eur J Clin Microbiol Infect Dis. 2012;31(10):2727–36. CrossRefPubMed
Morgan DJ, Day HR, Furuno JP, Young A, Johnson JK, Bradham DD, Perencevich EN. Improving efficiency in active surveillance for methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus at hospital admission. Infect Control Hosp Epidemiol. 2010;31(12):1230–5. CrossRefPubMedPubMedCentral
Harbarth S, Sax H, Fankhauser-Rodriguez C, Schrenzel J, Agostinho A, Pittet D. Evaluating the probability of previously unknown carriage of MRSA at hospital admission. Am J Med. 2006;119(3):275 e15–23. CrossRef
Robinson JO, Phillips M, Christiansen KJ, Pearson JC, Coombs GW, Murray RJ. Knowing prior methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization status increases the empirical use of glycopeptides in MRSA bacteraemia and may decrease mortality. Clin Microbiol Infect. 2014;20(6):530–5. CrossRefPubMed
Lawes T, Lopez-Lozano JM, Nebot CA, Macartney G, Subbarao-Sharma R, Dare CR, Wares KD, Gould IM. Effects of national antibiotic stewardship and infection control strategies on hospital-associated and community-associated meticillin-resistant Staphylococcus aureus infections across a region of Scotland: a non-linear time-series study. Lancet Infect Dis. 2015;15(12):1438–49. CrossRefPubMed
- Available, Bed-sided, Comprehensive (ABC) score to a diagnosis of Methicillin-resistant Staphylococcus aureus infection: a derivation and validation study
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