Modelo clínico predictivo y validación de bacteriemias por anaerobios (incluidas las bacteriemias polimicrobianas)

Introduction: Anaerobic bacteremias are uncommon. There is no agreement on their clinical predictability and the usefulness of anaerobic blood cultures. The objective of this study was to develop and validate a model for the prediction of anaerobic bacteremias. Method: The developing model was created with 984 bacteremias (45 anaerobic bacteremias) during 1985–1986 and 1996–1997. The validation model was made with 320 bacteremias during 2005–2006. Results: Independent multivariate predictors of true anaerobic bacteremia were used to develop a model stratifying patients with scores of 0 to 13 points(p), which were: unknown focus OR 3.46 (CI: 1.13–10.54) 3 p; abdominal and skin focus OR 14.85 (CI: 6.37–34.62) 6p; hypotension OR 1.99 (CI: 0.98–4.04) 2p; absence of vascular manipulations OR 2.62 (CI: 1.04–6.60) 2p and age over 60 years OR 3.21 (CI: 1.19–8.67) 3p. In the derivation sets group with more than 7p the model had Sensitivity: 77.8%, Specificity: 78.3%, PPV:14.7%, and a NPV of 98.6%. The area under curve was ROC=0.84 (SE=0.011), 95% CI: 0.82–0.86 with an