Performance Comparison of Infection Prediction Scores in a South African Neonatal Unit: A Retrospective Case-Control Study.
Performance Comparison of Infection Prediction Scores in a South African Neonatal Unit: A Retrospective Case-Control Study.
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DOI：
10.3389/fped.2022.830510
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发表时间：
2022
影响因子：
2.6
通讯作者：
Van Weissenbruch MM
中科院分区：
文献类型：
--
作者：
Lloyd LG;Dramowski A;Bekker A;Malou N;Ferreyra C;Van Weissenbruch MM
感染预测评分是确定新生儿医院获得性感染（HAI）可能性的有用辅助测试，特别是在极低出生体重（VLBW;<1，500 g）婴儿中，他们最容易受到HAI的影响，并且具有高抗生素使用率。现有的感染预测评分均未在南非VLBW新生儿中开发或评价。我们通过文献检索确定了现有的感染预测评分，并评估了每个评分在资源有限环境中使用的适用性和可行性。使用来自南非开普敦三级医院新生儿病房的VLBW婴儿（2016 - 2017年）回顾性数据集，比较适当评分的性能。计算每个评分的敏感性、特异性、预测值和似然比。确定了11个感染预测评分，但只有5个适合在资源有限的环境中使用（NOSEP 1，Singh，Rosenberg和Bekhof评分）。使用来自659名VLBW婴儿的841次HAI事件的数据对五个选定的评分进行评估。评分的敏感性范围为3%（NOSEP 1 ≥ 14;已证实和推定感染）至最高74%（Singh评分≥ 1;已证实感染）。这些评分的特异性范围为31%（Singh评分≥ 1;证实和推定感染）至100%（NOSEP 1 ≥ 11且≥ 14，NOSEP-NEW-1 ≥ 11;证实和推定感染）。现有的感染预测评分在南非极低出生体重婴儿中没有达到可比的预测性能，因此仅应用作抗菌决策中临床判断的辅助手段。未来的研究应该开发具有高诊断准确性的感染预测评分，并且在资源有限的新生儿病房实施是可行的。
Infection prediction scores are useful ancillary tests in determining the likelihood of neonatal hospital-acquired infection (HAI), particularly in very low birth weight (VLBW; <1,500 g) infants who are most vulnerable to HAI and have high antibiotic utilization rates. None of the existing infection prediction scores were developed for or evaluated in South African VLBW neonates. We identified existing infection prediction scores through literature searches and assessed each score for suitability and feasibility of use in resource-limited settings. Performance of suitable scores were compared using a retrospective dataset of VLBW infants (2016–2017) from a tertiary hospital neonatal unit in Cape Town, South Africa. Sensitivity, specificity, predictive values, and likelihood ratios were calculated for each score. Eleven infection prediction scores were identified, but only five were suitable for use in resource-limited settings (NOSEP1, Singh, Rosenberg, and Bekhof scores). The five selected scores were evaluated using data from 841 episodes of HAI in 659 VLBW infants. The sensitivity for the scores ranged between 3% (NOSEP1 ≥14; proven and presumed infection), to a maximum of 74% (Singh score ≥1; proven infection). The specificity of these scores ranged from 31% (Singh score ≥1; proven and presumed infection) to 100% (NOSEP1 ≥11 and ≥14, NOSEP-NEW-1 ≥11; proven and presumed infection). Existing infection prediction scores did not achieve comparable predictive performance in South African VLBW infants and should therefore only be used as an adjunct to clinical judgment in antimicrobial decision making. Future studies should develop infection prediction scores that have high diagnostic accuracy and are feasible to implement in resource-limited neonatal units.
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影响因子：
2.1
作者：
Paolucci M;Landini MP;Sambri V
通讯作者：
Sambri V
影响因子：
8.8
作者：
Mahieu, LM;De Muynck, AO;Van Acker, KJ
通讯作者：
Van Acker, KJ
DOI：
10.1038/sj.jp.7211404
发表时间：
2005-12-01
期刊：
Journal of perinatology : official journal of the California Perinatal Association
影响因子：
--
作者：
Okascharoen, Chusak;Sirinavin, Sayomporn;Supapanachart, Sarayut
通讯作者：
Supapanachart, Sarayut
影响因子：
168.9
作者：
Liu, Li;Oza, Shefali;Hogan, Dan;Chu, Yue;Perin, Jamie;Zhu, Jun;Lawn, Joy E.;Cousens, Simon;Mathers, Colin;Black, Robert E.
通讯作者：
Black, Robert E.
影响因子：
2.6
作者：
Dillenseger, Laurence;Langlet, Claire;Kuhn, Pierre
通讯作者：
Kuhn, Pierre