• Agustín Julián-Jiménez, Eric Jorge García-Lamberechts, Juan González Del Castillo, Carmen Navarro Bustos, Ferrán Llopis-Roca, Mikel Martínez-Ortiz de Zarate, Pascual Piñera Salmerón, Josep María Guardiola Tey, Jesús Álvarez-Manzanares, Julio Javier Gamazo-Del Rio, Itziar Huarte Sanz, Rafael Rubio Díaz, Marta Álvarez Alonso, Begoña Mora Ordoñez, Oscar Álvarez López, María Del Mar Ortega Romero, Francisco Javier Candel González, and en nombre de los investigadores del grupo INFURG-SEMES.
• Servicio de Urgencias, Complejo Hospitalario Universitario de Toledo, Toledo, España. Electronic address: agustinj@sescam.jccm.es.
• Enferm Infecc Microbiol Clin (Engl Ed). 2021 Feb 10.

ObjectiveTo validate a simple risk score to predict bacteremia (MPB5-Toledo) in patients seen in the emergency departments (ED) due to infections.MethodsProspective and multicenter observational cohort study of the blood cultures (BC) ordered in 74 Spanish ED for adults (aged 18 or older) seen from from October 1, 2019, to February 29, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC). The prognostic performance for true bacteremia was calculated with the cut-off values chosen for getting the sensitivity, specificity, positive predictive value and negative predictive value.ResultsA total of 3.843 blood samples wered cultured. True cases of bacteremia were confirmed in 839 (21.83%). The remaining 3.004 cultures (78.17%) were negative. Among the negative, 172 (4.47%) were judged to be contaminated. Low risk for bacteremia was indicated by a score of 0 to 2 points, intermediate risk by 3 to 5 points, and high risk by 6 to 8 points. Bacteremia in these 3 risk groups was predicted for 1.5%, 16.8%, and 81.6%, respectively. The model's area under the receiver operating characteristic curve was 0.930 (95% CI, 0.916-0.948). The prognostic performance with a model's cut-off value of ≥ 5 points achieved 94.76% (95% CI: 92.97-96.12) sensitivity, 81.56% (95% CI: 80.11-82.92) specificity, and negative predictive value of 98.24% (95% CI: 97.62-98.70).ConclusionThe 5MPB-Toledo score is useful for predicting bacteremia in patients attended in hospital emergency departments for infection.Copyright © 2021 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Publicado por Elsevier España, S.L.U. All rights reserved.

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