Intensive care infection score outperforms inflammatory biomarkers in detecting infection in critically ill patients.

IF 3.9 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2026-10-07 DOI:10.1007/s15010-026-02984-8

Noelle Nacke, Christian Hönemann, Bastian Blömer, Stefanie Klatte, Alexander Zarbock, Jens-Christian Schewe, Marie-Luise Rübsam

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引用次数: 0

Abstract

Purpose: Identification of infection in critically ill patients remains challenging, as conventional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT) and white blood cell count (WBC) frequently lack diagnostic accuracy. The Intensive Care Infection Score (ICIS), a host-response biomarker derived from hematological parameters, reflects both innate and adaptive immune response.

Methods: To compare diagnostic performance of ICIS, CRP, PCT, and WBC, expert adjudication was used to determine presence or absence of infection. Diagnostic accuracy parameters including receiver operating characteristic curve analysis were calculated.

Results: 770 samples from 382 critically ill patients were included. ICIS demonstrated the highest diagnostic accuracy with an area under the curve (AUC) of 0.914 (95% CI 0.892-0.933), compared with CRP (AUC 0.889; 95% CI 0.865-0.910), PCT (AUC 0.847; 95% CI 0.819-0.871), and WBC (AUC 0.697; 95% CI 0.663-0.729). At the optimal cut-off value of > 3, ICIS achieved a sensitivity of 80.7% and specificity of 89.3%. ICIS showed the lowest false-positive rate (10.7%) and a negative predictive value of 88.7%.

Conclusion: ICIS demonstrated good diagnostic performance in critically ill patients and can contribute to antimicrobial stewardship as a novel host-response diagnostic.

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重症监护感染评分在检测重症患者感染方面优于炎症生物标志物。

目的：由于传统的生物标志物如c反应蛋白（CRP）、降钙素原（PCT）和白细胞计数（WBC）经常缺乏诊断准确性，鉴定危重患者感染仍然具有挑战性。重症监护感染评分（ICIS）是一种源自血液学参数的宿主反应生物标志物，反映先天和适应性免疫反应。方法：比较ICIS、CRP、PCT和WBC的诊断性能，采用专家评判来确定是否存在感染。计算诊断准确度参数，包括受试者工作特征曲线分析。结果：共纳入382例危重患者770例样本。与CRP （AUC 0.889; 95% CI 0.865-0.910）、PCT （AUC 0.847; 95% CI 0.819-0.871）和WBC （AUC 0.697; 95% CI 0.663-0.729）相比，ICIS表现出最高的诊断准确性，曲线下面积（AUC）为0.914 （95% CI 0.892-0.933）。在最佳临界值bb0.3下，ICIS的敏感性为80.7%，特异性为89.3%。ICIS的假阳性率最低（10.7%），阴性预测值为88.7%。结论：ICIS在危重患者中具有良好的诊断效果，可作为一种新的宿主反应诊断方法用于抗菌药物管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.