{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T22:23:50Z","timestamp":1762899830588,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T00:00:00Z","timestamp":1573084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["087769\/Z\/08\/Z"],"award-info":[{"award-number":["087769\/Z\/08\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32HL007287"],"award-info":[{"award-number":["T32HL007287"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The quick sequential organ failure assessment (qSOFA) score has had limited validation in lower resource settings and was developed using data from high-income countries. We sought to evaluate the predictive validity of the qSOFA score for sepsis within a low- and middle-income country (LMIC) population with culture-proven staphylococcal infection. This was a secondary analysis of a prospective multicenter cohort in Thailand with culture-positive infection due to Staphylococcus aureus or S. argenteus within 24 h of admission and positive (\u22652\/4) systemic inflammatory response syndrome (SIRS) criteria. Primary exposure was maximum qSOFA score within 48 h of culture collection and primary outcome was mortality at 28 days. Baseline risk of mortality was determined using a multivariable logistic regression model with age, gender, and co-morbidities significantly associated with the outcome. Predictive validity was assessed by discrimination of mortality using area under the receiver operating characteristic (AUROC) curve compared to a model using baseline risk factors alone. Of 253 patients (mean age 54 years (SD 16)) included in the analysis, 23 (9.1%) died by 28 days after enrollment. Of those who died, 0 (0%) had a qSOFA score of 0, 8 (35%) had a score of 1, and 15 (65%) had a score \u22652. The AUROC of qSOFA plus baseline risk was significantly greater than for the baseline risk model alone (AUROCqSOFA = 0.80 (95% CI, 0.70\u20130.89), AUROCbaseline = 0.62 (95% CI, 0.49\u20130.75); p &lt; 0.001). Among adults admitted to four Thai hospitals with community-onset coagulase-positive staphylococcal infection and SIRS, the qSOFA score had good predictive validity for sepsis.<\/jats:p>","DOI":"10.3390\/jcm8111908","type":"journal-article","created":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T11:17:25Z","timestamp":1573125445000},"page":"1908","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Predictive Validity of the qSOFA Score for Sepsis in Adults with Community-Onset Staphylococcal Infection in Thailand"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9431-5326","authenticated-orcid":false,"given":"Supaksh","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle, WA 98195, USA"},{"name":"Division of Pulmonary, Sleep, and Critical Care Medicine, University of Washington, Seattle, WA 98195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6695-8401","authenticated-orcid":false,"given":"Kristina E.","family":"Rudd","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Sleep, and Critical Care Medicine, University of Washington, Seattle, WA 98195, USA"},{"name":"Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarunporn","family":"Tandhavanant","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, 420\/6 Rajvithi Road, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pornpan","family":"Suntornsut","sequence":"additional","affiliation":[{"name":"Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ploenchan","family":"Chetchotisakd","sequence":"additional","affiliation":[{"name":"Department of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7026-5181","authenticated-orcid":false,"given":"Derek C.","family":"Angus","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon J.","family":"Peacock","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narisara","family":"Chantratita","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, 420\/6 Rajvithi Road, Bangkok 10400, Thailand"},{"name":"Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5503-7204","authenticated-orcid":false,"given":"Timothy Eoin","family":"West","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Sleep, and Critical Care Medicine, University of Washington, Seattle, WA 98195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/S2213-2600(14)70061-X","article-title":"Assessment of the worldwide burden of critical illness: The intensive care over nations (ICON) audit","volume":"2","author":"Vincent","year":"2014","journal-title":"Lancet Respir. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1164\/rccm.201504-0781OC","article-title":"Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations","volume":"193","author":"Fleischmann","year":"2016","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"978","DOI":"10.4269\/ajtmh.2006.75.978","article-title":"Causes of community-acquired bacteremia and patterns of antimicrobial resistance in Vientiane, Laos","volume":"75","author":"Phetsouvanh","year":"2006","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_4","first-page":"8","article-title":"Risk factors for predicting mortality in a surgical intensive care unit in the year 2000","volume":"86","author":"Bunburaphong","year":"2003","journal-title":"J. Med. Assoc. Thail. Chotmaihet Thangphaet"},{"key":"ref_5","first-page":"355","article-title":"Clinical features of community-acquired pneumonia treated at Srinagarind Hospital, Khon Kaen, Thailand","volume":"33","author":"Reechaipichitkul","year":"2002","journal-title":"S. Asian J. Trop. Med. Public Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/S1473-3099(06)70363-2","article-title":"Methicillin-resistant Staphylococcus aureus in rural Asia","volume":"6","author":"Nickerson","year":"2006","journal-title":"Lancet Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.ijantimicag.2018.08.017","article-title":"High mortality impact of Staphylococcus argenteus on patients with community-onset staphylococcal bacteraemia","volume":"52","author":"Chen","year":"2018","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1378\/chest.101.6.1644","article-title":"Definitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in Sepsis","volume":"101","author":"Bone","year":"1992","journal-title":"Chest"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1007\/s00134-003-1662-x","article-title":"2001 SCCM\/ESICM\/ACCP\/ATS\/SIS International Sepsis Definitions Conference","volume":"29","author":"Levy","year":"2003","journal-title":"Intensive Care Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e113","DOI":"10.1097\/CCM.0000000000001730","article-title":"A Framework for the Development and Interpretation of Different Sepsis Definitions and Clinical Criteria","volume":"44","author":"Angus","year":"2016","journal-title":"Crit. Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1001\/jama.2016.20329","article-title":"Prognostic Accuracy of Sepsis-3 Criteria for In-Hospital Mortality Among Patients with Suspected Infection Presenting to the Emergency Department","volume":"317","author":"Freund","year":"2017","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1001\/jama.2016.20328","article-title":"Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults with Suspected Infection Admitted to the Intensive Care Unit","volume":"317","author":"Raith","year":"2017","journal-title":"JAMA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2202","DOI":"10.1001\/jama.2018.6229","article-title":"Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score with Excess Hospital Mortality in Adults with Suspected Infection in Low- and Middle-Income Countries","volume":"319","author":"Rudd","year":"2018","journal-title":"JAMA"},{"key":"ref_15","first-page":"1042","article-title":"Patient Characteristics, Management, and Predictors of Outcome from Severe Community-Onset Staphylococcal Sepsis in Northeast Thailand: A Prospective Multicenter Study","volume":"96","author":"West","year":"2017","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"47.e1","DOI":"10.1016\/j.cmi.2016.08.028","article-title":"TLR4 genetic variation is associated with inflammatory responses in Gram-positive sepsis","volume":"23","author":"Chantratita","year":"2017","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"458.e11","DOI":"10.1016\/j.cmi.2016.01.008","article-title":"Comparison of community-onset Staphylococcus argenteus and Staphylococcus aureus sepsis in Thailand: A prospective multicentre observational study","volume":"22","author":"Chantratita","year":"2016","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e00802-17","DOI":"10.1128\/mBio.00802-17","article-title":"Evolution of the ST2250 Clone in Northeastern Thailand Is Linked with the Acquisition of Livestock-Associated Staphylococcal Genes","volume":"8","author":"Moradigaravand","year":"2017","journal-title":"mBio"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1097\/00005373-199805000-00016","article-title":"The conundrum of the Glasgow Coma Scale in intubated patients: A linear regression prediction of the Glasgow verbal score from the Glasgow eye and motor scores","volume":"44","author":"Meredith","year":"1998","journal-title":"J. Trauma"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1111\/aas.12554","article-title":"In-hospital vs. 30-day mortality in the critically ill\u2014A 2-year Swedish intensive care cohort analysis","volume":"59","author":"Rydenfelt","year":"2015","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1099\/ijs.0.062752-0","article-title":"Novel staphylococcal species that form part of a Staphylococcus aureus-related complex: The non-pigmented Staphylococcus argenteus sp. nov. and the non-human primate-associated Staphylococcus schweitzeri sp.","volume":"65","author":"Tong","year":"2015","journal-title":"Nov. Int. J. Syst. Evol. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1016\/j.ajem.2018.03.014","article-title":"Mortality outcomes based on ED qSOFA score and HIV status in a developing low income country","volume":"36","author":"Aluisio","year":"2018","journal-title":"Am. J. Emerg. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1186\/s13054-018-2157-z","article-title":"The global burden of sepsis: Barriers and potential solutions","volume":"22","author":"Rudd","year":"2018","journal-title":"Crit. Care"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Minejima, E., Delayo, V., Lou, M., Ny, P., Nieberg, P., She, R.C., and Wong-Beringer, A. (2019). Utility of qSOFA score in identifying patients at risk for poor outcome in Staphylococcus aureus bacteremia. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-3770-4"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1097\/00003246-199908000-00039","article-title":"Clinical gram-positive sepsis: Does it fundamentally differ from gram-negative bacterial sepsis?","volume":"27","author":"Opal","year":"1999","journal-title":"Crit. Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"R27","DOI":"10.1186\/cc8898","article-title":"Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia","volume":"14","author":"Abe","year":"2010","journal-title":"Crit. Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1164\/rccm.201412-2323OC","article-title":"Global epidemiology of pediatric severe sepsis: The sepsis prevalence, outcomes, and therapies study","volume":"191","author":"Weiss","year":"2015","journal-title":"Am. J. Respir. Crit. Care Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/11\/1908\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:32:40Z","timestamp":1760189560000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/11\/1908"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,7]]},"references-count":27,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11]]}},"alternative-id":["jcm8111908"],"URL":"https:\/\/doi.org\/10.3390\/jcm8111908","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2019,11,7]]}}}