Division of Infection Control and Prevention, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan.
BMC Infect Dis. 2018 Jan 8;18(1):19. doi: 10.1186/s12879-017-2919-2.
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.
耐甲氧西林金黄色葡萄球菌（MRSA）感染仍是全球医疗机构的一个主要问题。
本单中心回顾性队列研究包括推导阶段和验证阶段。推导阶段包括 2010 年 5 月至 2011 年 4 月期间入住大阪大学医院的所有患者。我们提出了一个暂定的、床边的、全面的（ABC）评分，并使用临床诊断作为参考来评估其准确性。随后，我们根据每个变量的 k 系数评分对 ABC 评分进行了修订；通过将其应用于另一个患者群体来验证修订后的评分。
总共纳入了 172 名患者和 154 例病例，分别用于推导和验证研究。修订后的 ABC 评分由四个简单变量组成：临床标本类型（1 至 3 分）、革兰氏染色结果（1 分）、局部炎症存在（2 分）和全身炎症反应（2 分）。修订后的评分≥5 分具有较高的敏感性（93.8%）和特异性（90.6%），接受者操作特征曲线下面积为 0.969（95%置信区间；0.957-1）。
我们开发了一种用于诊断医院获得性 MRSA 感染的简单而全面的评分系统；该系统适用于各种情况。
