University Medicine Cluster, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Am J Trop Med Hyg. 2013 Oct;89(4):804-10. doi: 10.4269/ajtmh.13-0197. Epub 2013 Aug 26.
We aim to construct a diagnostic model for bacterial coinfection in dengue patients (Dengue Dual Infection Score [DDIS]); 2,065 adult dengue patients (mean age = 41.9 ± 17.2 years, 58.4% male, 83 patients with bacterial coinfection) seen at a university hospital from January of 2005 to February of 2010 were studied. The DDIS was created by assigning one point to each of five risk factors for bacterial coinfection: pulse rate ≥ 90 beats/minute, total white cell count ≥ 6 × 10(9)/L, hematocrit < 40%, serum sodium < 135 mmol/L, and serum urea ≥ 5 mmol/L. The DDIS identified bacterial coinfection (derivation set area under the curve = 0.793, 95% confidence interval = 0.732-0.854; validation set area under the curve = 0.761, 95% confidence interval = 0.637-0.886). A DDIS of ≥ 4 had a specificity of 94.4%, whereas a DDIS of ≥ 1 had a sensitivity of 94.4% for bacterial coinfection. The DDIS can help to select dengue patients for early bacterial cultures and empirical antibiotics.
我们旨在构建一个用于诊断登革热患者细菌合并感染的模型（登革热双重感染评分[DDIS]）；研究了 2005 年 1 月至 2010 年 2 月期间在一家大学医院就诊的 2065 例成年登革热患者（平均年龄=41.9±17.2 岁，男性占 58.4%，83 例患者合并细菌感染）。DDIS 通过为五个细菌合并感染的风险因素各分配 1 分来构建：脉搏≥90 次/分钟，总白细胞计数≥6×10(9)/L，血细胞比容<40%，血清钠<135mmol/L，血清尿素≥5mmol/L。DDIS 可识别细菌合并感染（验证集曲线下面积=0.761，95%置信区间=0.637-0.886）。DDIS≥4 分的特异性为 94.4%，而 DDIS≥1 分的敏感性为 94.4%。DDIS 有助于选择登革热患者进行早期细菌培养和经验性抗生素治疗。
