Tóm tắt
Background: Multidrug-resistant (MDR) bacterial infection is a serious global health problem, especially in Intensive Care Units (ICUs). The ICU-SEPSA score was developed to predict mortality in patients with MDR infections.
Objective: To evaluate the prognostic value of the ICU-SEPSA score for predicting mortality among ICU patients with MDR bacterial infections at Hue Central Hospital.
Methods: We conducted a prospective observational study of 108 patients with MDR bacterial infections admitted to the ICU from June 2024 to June 2025. ICU-SEPSA was recorded at the time the index culture was identified. Univariate logistic regression examined the association between ICU-SEPSA and mortality. Discrimination was evaluated using receiver operating characteristic (ROC) analysis to determine the optimal cut-off, area under the curve (AUC), sensitivity, and specificity. An exploratory combined model with the SOFA score was derived using logistic regression, yielding a linear predictor SOFA + 1.104 × ICU-SEPSA.
Results: The overall mortality was 77.8%. The mean ICU-SEPSA score at the time of culture isolation was 7.0 ± 1.9. On univariate analysis, ICU-SEPSA predicted mortality (OR = 1.420; p < 0.001). At a cut-off value of 7.3, ICU-SEPSA demonstrated moderate discrimination (AUC = 0.686), with 56.0% sensitivity and 83.3% specificity. The exploratory combined model (SOFA + 1.104 × ICU-SEPSA) demonstrated better discrimination (AUC = 0.773); at a cut-off of 10.2, sensitivity was 95.2% and specificity 50.0%.
Conclusions: The ICU-SEPSA score has prognostic value for mortality in ICU patients with MDR bacterial infections, and combining ICU-SEPSA with SOFA further improves predictive performance.
| Đã xuất bản | 25-08-2026 | |
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| Số tạp chí | Tập 16 Số 04 (2026) | |
| Phân mục | Nghiên cứu | |
| DOI | 10.34071/jmp.2026.4.1021 | |
| Từ khóa |
công trình này được cấp phép theo Creative Commons Attribution-phi thương mại-NoDerivatives 4.0 License International . p>
Bản quyền (c) 2026 Tạp chí Y Dược Huế
Murray CJL, Ikuta KS, Sharara F, Swetschinski L, Robles Aguilar G, Gray A, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet. 2022;399(10325):629-55.
World Health Organization: New report calls for urgent action to avert antimicrobial resistance crisis. https://www.who.int/news/item/29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisis (2019).
O'Neill J. Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations. The Review on Antimicrobial Resistance; 2014.
Oh Y, Roh J, Lee J, Chung HS, Lee K, Lee MK. Sequential Organ Failure Assessment score as a predictor of mortality in ventilated patients with multidrug-resistant bacteremia. Acute and Critical Care. 2020;35(3):169-78.
Hariyanto H, Yahya CQ, Cucunawangsih C, Pertiwi CLP. Antimicrobial resistance and mortality. Afr J Infect Dis. 2022;16(2):13-20.
Chen Y-P, Tasi X-W, Chang K, Cao X-D, Chen J-R, Liao C-S. Multi-Drug Resistant Organisms Infection Impact on Patients Length of Stay in Respiratory Care Ward. Antibiotics. 2021;10(5):608.
Al-Hasan MN, Lahr BD, Eckel-Passow JE, Baddour LM. Predictive scoring model of mortality in Gram-negative bloodstream infection. Clinical Microbiology and Infection. 2013;19(10):948-54.
Sirichayanugul Taranee, Srisawat Chansinee, Thummakomut C, Prawang Abhisit, Huynh Nina S., Saokaew Surasak, et al. Development and internal validation of simplified predictive scoring (ICU-SEPSA score) for mortality in patients with multidrug resistant infection. Frontiers in Pharmacology. 2022;13.
Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clinical Microbiology and Infection. 2012;18(3):268-81.
Delves PJ, Roitt IM. The Immune System. New England Journal of Medicine. 2000;343(1):37-49.
Yassin Ahmed, Eid RA, Mohammad MF, Elgendy MO, Mohammed Z, Abdelrahim MEA, et al. Microbial Multidrug-Resistant Organism (MDRO) Mapping of Intensive Care Unit Infections. Medicina. 2025;61(7):1220.
Dinh Phung Tran, Quang Dai Huynh, Thi Ngoc Thao Pham. Ventilator-associated pneumonia at Cho Ray Hospital. *Ho Chi Minh City Journal of Medicine (Supplement). 2016;20(1):91–95.
Wei Z, Zhou S, Zhang Y, Zheng L, Zhao L, Cui Y, et al. Microbiological characteristics and risk factors on prognosis associated with Acinetobacter baumannii bacteremia in general hospital: A single-center retrospective study. Frontiers in Microbiology. 2022;13.
Maia Marcelo De Oliveira, Da Silveira CDG, Gomes M, Fernandes SES, Bezerra De Santana R, De Oliveira DQ, et al. Multidrug-Resistant Bacteria on Critically Ill Patients with Sepsis at Hospital Admission: Risk Factors and Effects on Hospital Mortality. Infection and Drug Resistance. 2023;Volume 16:1693-704.







