| Autor: |
Ngiam JN; Division of Infectious Diseases, National University Hospital, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore 119228, Singapore., Koh MCY; Division of Infectious Diseases, National University Hospital, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore 119228, Singapore., Archuleta S; Division of Infectious Diseases, National University Hospital, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore 119228, Singapore.; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore., Fisher D; Division of Infectious Diseases, National University Hospital, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore 119228, Singapore.; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore., Chai LY; Division of Infectious Diseases, National University Hospital, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore 119228, Singapore.; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore., Sia CH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore.; Department of Cardiology, National University Heart Centre Singapore, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 9, Singapore 119228, Singapore., Kong WKF; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore.; Department of Cardiology, National University Heart Centre Singapore, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 9, Singapore 119228, Singapore., Tambyah PA; Division of Infectious Diseases, National University Hospital, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore 119228, Singapore.; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore.; Infectious Diseases Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore. |
| Abstrakt: |
Background : Several risk scores have been derived to predict the risk of infective endocarditis (IE) amongst patients with Staphylococcus aureus bacteraemia (SAB), which helps to guide clinical management. Methods : We prospectively studied 634 patients admitted with SAB. The cohort was stratified into those with or without IE, and the PREDICT Day 1, Day 5 and VIRSTA scores were tabulated. Area under the receiver operating characteristic (AUC) curves were constructed to compare the performance of each score. Results : Of the 634 patients examined, 36 (5.7%) had IE. These patients were younger (51.6 ± 20.1 vs. 59.2 ± 18.0 years, p = 0.015), tended to have community acquisition of bacteraemia (41.7% vs. 17.9%, p < 0.001), and had persistent bacteraemia beyond 72 h (19.4% vs. 6.0%, p = 0.002). The VIRSTA score had the best performance in predicting IE (AUC 0.76, 95%CI 0.66-0.86) compared with PREDICT Day 1 and Day 5. A VIRSTA score of <3 had the best negative predictive value (97.5%), compared with PREDICT Day 1 (<4) and Day 5 (<2) (94.3% and 96.6%, respectively). Conclusions : Overall, the risk scores performed well in our Asian cohort. If applied, 23.5% of the cohort with a VIRSTA ≥ 3 would require TEE, and a score of <3 had an excellent negative predictive value. |
