Bedside Risk Score of Miller and Johnson for Carbapenem-Resistant Enterobacteriaceae

Description

Miller and Johnson developed a simple bedside score for identifying a patient at risk for developing an infection with a carbapenem-resistant Enterobacteriaceae. This can help to identify a patient who may benefit from more aggressive management. The authors are from Campbell University and Novant Health Forsyth Medical Center in North Carolina.

Patient selection: community hospital

Outcome: development of a carbapenem-resistant infection

Parameters:

(1) antibiotics within the 90 days prior to the positive culture

(2) immunosuppression within the 90 days prior to the positive culture

(3) Charlson comorbidity index (CCI)

Parameter	Finding	Points
recent antibiotics	no	0
	yes	4
recent immunosuppression	no	0
	yes	3
Charlson Comorbidity Index	0 to 3	0
	>= 4	2

total score =

= SUM(points for all 3 parameters)

Interpretation:

• minimum score: 0

• maximum score: 9

• A score >= 5 was the most accurate (79%).

Performance:

• The area under the ROC curve is 0.83.

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Bedside Risk Score of Miller and Johnson for Carbapenem-Resistant Enterobacteriaceae

Description

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