Un score simple pour prédire la présence de bactérie(s) nécessitant un traitement par carbapénème dans les bactériémies et pneumonies associées aux soins survenues en réanimation : le CarbaSCORE

Abstract : Objective: risk factors of multi drug resistant bacteria in health care associated infections are suggested by scientific societies, but no scoring system is actually recommended for guiding antibiotic therapy. We aimed to create a predictive score of bacteria requiring carbapenem treatment in health care associated bloodstream infections and pneumonias in intensive care units. Material and methods: during 4 years, we achieved a retrospective study in the polyvalent intensive care unit of Félix Guyon hospital, a University Medical Center in La Réunion. All patients with health care relative bloodstream infection or pneumonia were included. Bi-variate analysis and multivariate analysis was performed for setting up the CarbaSCORE, followed by an internal validation. Results : we analysed 338 patients including 27 which requiring carbapenem. Finally, CarbaSCORE was made of 4 items: “presence of bloodstream infection” (rather than pneumonia) marking 2 points, “preceding use of antibiotics Weiss’s class ≥ 3” marking 3 points, “chronic hemodialysis” marking 4 points and “foreign trip during the past 6 months” marking 5 points. Bootstrap for internal validation showed an area under the curve of receiver operating characteristics at 0,79 [0,70-0,87]. The sensitivity value at cut-off 5 was 78%the specificity value at cut-off 8 was 92%. Conclusion: the CarbaSCORE is a simple and efficient score for predicting a bacterial infection requiring a carbapenem use. Furthers studies are needed to test its limits before practical use.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02093154
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Submitted on : Monday, April 8, 2019 - 4:41:06 PM
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Laura Teysseyre. Un score simple pour prédire la présence de bactérie(s) nécessitant un traitement par carbapénème dans les bactériémies et pneumonies associées aux soins survenues en réanimation : le CarbaSCORE. Médecine humaine et pathologie. 2018. ⟨dumas-02093154⟩

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