{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T19:34:38Z","timestamp":1770492878014,"version":"3.49.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003509","name":"\u00d6rebro University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003509","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Blood stream infection (BSI) and sepsis are serious clinical conditions and identification of the disease-causing pathogen is important for patient management. The RISE (Rapid Identification of SEpsis) study was carried out to collect a cohort allowing high-quality studies on different aspects of BSI and sepsis. The aim of this study was to identify patients at high risk for BSI who might benefit most from new, faster, etiological testing using neutrophil to lymphocyte count ratio (NLCR) and Shapiro score.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Adult patients (\u2265 18\u2009years) presenting at the emergency department (ED) with suspected BSI were prospectively included between 2014 and 2016 at \u00d6rebro University Hospital. Besides extra blood sampling, all study patients were treated according to ED routines. Electronic patient charts were retrospectively reviewed. A modified Shapiro score (MSS) and NLCR were extracted and compiled. Continuous score variables were analysed with area under receiver operator characteristics curves (AUC) to evaluate the ability of BSI prediction.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The final cohort consisted of 484 patients where 84 (17%) had positive blood culture judged clinically significant. At optimal cut-offs, MSS (\u22653 points) and NLCR (&gt;\u200912) showed equal ability to predict BSI in the whole cohort (AUC 0.71\/0.74; sensitivity 69%\/67%; specificity 64%\/68% respectively) and in a subgroup of 155 patients fulfilling Sepsis-3 criteria (AUC 0.71\/0.66; sensitivity 81%\/65%; specificity 46%\/57% respectively). In BSI cases only predicted by NLCR&gt;\u200912 the abundance of Gram-negative to Gram-positive pathogens (<jats:italic>n<\/jats:italic>\u2009=\u200913 to <jats:italic>n<\/jats:italic>\u2009=\u20094) differed significantly from those only predicted by MSS \u22653 p (<jats:italic>n<\/jats:italic>\u2009=\u20097 to <jats:italic>n<\/jats:italic>\u2009=\u200912 respectively) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>MSS and NLCR predicted BSI in the RISE cohort with similar cut-offs as shown in previous studies. Combining the MSS and NLCR did not increase the predictive performance. Differences in BSI prediction between MSS and NLCR regarding etiology need further evaluation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-05990-3","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T11:02:54Z","timestamp":1617361374000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Early prediction of blood stream infection in a prospectively collected cohort"],"prefix":"10.1186","volume":"21","author":[{"given":"David","family":"Nestor","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Andersson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pernilla","family":"Kihlberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Olson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid","family":"Ziegler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunl\u00f6g","family":"Rasmussen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"K\u00e4llman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Cajander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"M\u00f6lling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Sundqvist","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,4,2]]},"reference":[{"issue":"6","key":"5990_CR1","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1111\/1469-0691.12195","volume":"19","author":"M Goto","year":"2013","unstructured":"Goto M, Al-Hasan MN. 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Patients could be included within 14\u2009days after first sampling if they were unable to give consent due to disease severity at time of admission. Patients could at any time withdraw from the study. All samples obtained from patients were destroyed if consent did not arrive to the laboratory within 14\u2009days post inclusion or if consent was withdrawn. The study received approval from the Regional Ethical Review Board Uppsala, Sweden, Sep. 2014 (dnr 2014\/193).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"316"}}