External validation of INCREMENT-CPE score in a retrospective cohort of carbapenemase-producing Klebsiella pneumoniae bloodstream infections in critically ill patients

ObjectivesOur aim was to validate the INCREMENT-CPE score (ICS) in patients hospitalized intensive care unit (ICU) with bacteraemia due carbapenemase-producing Klebsiella pneumoniae (CP-Kp).MethodsThe study conducted ICU of University General Hospital Patras, Greece, during a 10-year period (2010–2019). Patients monomicrobial CP-Kp were included. Primary outcome 14-day mortality. MICs meropenem, tigecycline, fosfomycin and ceftazidime/avibactam determined by Etest, whereas for colistin broth microdilution method applied. PCR blaKPC, blaVIM, blaNDM blaOXA genes used.ResultsAmong 384 bacteraemias, most primary (166, 43.2%) followed catheter-related (143, 37.2%). Most isolates carried blaKPC (318, 82.8%). Fourteen-day mortality 26.3% (101 patients). ICS 11.1 ± 4.2. An ≥10 showed sensitivity 98.0% negative predictive value 98.7%. The area under curve (0.800) comparable those Pitt (0.799), Simplified Acute Physiology Score II (SAPS II) (0.797) Sequential Organ Failure Assessment (SOFA) (0.815).ConclusionsICS efficacy similar that SAPS II, SOFA scores.