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A bacteraemia risk prediction model: development and validation in an emergency medicine population

  • Original Paper
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Abstract

Objective

Design a risk model to predict bacteraemia in patients attended in emergency departments (ED) for an episode of infection.

Methods

This was a national, prospective, multicentre, observational cohort study of blood cultures (BC) collected from adult patients (≥ 18 years) attended in 71 Spanish EDs from October 1 2019 to March 31, 2020. Variables with a p value < 0.05 were introduced in the univariate analysis together with those of clinical significance. The final selection of variables for the scoring scale was made by logistic regression with selection by introduction. The results obtained were internally validated by dividing the sample in a derivation and a validation cohort.

Results

A total of 4,439 infectious episodes were included. Of these, 899 (20.25%) were considered as true bacteraemia. A predictive model for bacteraemia was defined with seven variables according to the Bacteraemia Prediction Model of the INFURG-SEMES group (MPB-INFURG-SEMES). The model achieved an area under the curve-receiver operating curve of 0.924 (CI 95%:0.914–0.934) in the derivation cohort, and 0.926 (CI 95%: 0.910–0.942) in the validation cohort. Patients were then split into ten risk categories, and had the following rates of risk: 0.2%(0 points), 0.4%(1 point), 0.9%(2 points), 1.8%(3 points), 4.7%(4 points), 19.1% (5 points), 39.1% (6 points), 56.8% (7 points), 71.1% (8 points), 82.7% (9 points) and 90.1% (10 points). Findings were similar in the validation cohort. The cut-off point of five points provided the best precision with a sensitivity of 95.94%, specificity of 76.28%, positive predictive value of 53.63% and negative predictive value of 98.50%.

Conclusion

The MPB-INFURG-SEMES model may be useful for the stratification of risk of bacteraemia in adult patients with infection in EDs, together with clinical judgement and other variables independent of the process and the patient.

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Availability of data and materials

The datasets used and/or analysed during the present study are available from the corresponding author upon reasonable request.

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Acknowledgements

Esperanza Ansa Arlegui, Igor Gallastegi Ruiz de Egino, Ricardo Palenzuela Arozena, Nerea Sarriegi Gorrotxategi, Xabier Errazkin Telletxea, Laura Munguía Nieva, Diego Vicente Anza, Maitane Arrastia Erviti (Hospital Universitario de Donosti), Isabel Nieto Rojas, William Esnaider López Forero, Elena Sánchez Maganto, Raúl Canabal Berlanga (Complejo Hospitalario Universitario de Toledo), Isabel María Morales Barroso, María Carmen Manzano Alba, Fernando Oltra Hostalet, José Gallardo Bautista, María Angustias Sevilla Espejo (Hospital Virgen de la Macarena de Sevilla), María Jesús Domínguez García, Mª Eugenia Barrero Ramos, Cristina Latorre Marco, Gema Delgado Cárdenas, Alberto Sánchez Bernal, Ángela Flores Palacio, Laura Martínez Vega, Laura Pérez Calero, Teresa Rincón Sánchez (Hospital Universitario de Fuenlabrada), M. Lourdes Nieto de Haro, Jerónimo Amores Fernández (Hospital Virgen de la Victoria de Málaga), Pablo Jerez-Fernández, Miguel Suarez-Robles, Clara Ramos-Rey, Ines Armenteros Yeguas, María Fernández-Revaldería, Eva Orviz García (Hospital Universitario Clínico San Carlos de Madrid), Silvia Álvarez Kailis, Beatriz Paderne Díaz, Gema María Gómez García, Alicia Rodríguez Urgel (Hospital Universitario de Móstoles), Sebastià Quetglas Roselló, Manel Tuells Morales, Marta Maristany Bosch, Ana Badía Tejero (Hospital Universitario de Bellvitge), Idoia Madariaga Ordeñana, Ainhoa Burzako Sánchez, (Hospital Universitario de Basurto), Omar Saavedra, Nuria Seguí, Leticia Fresco, Gina Osorio, Julia Calvo, Joan Ribot, Irene Carbonell (Hospital Clínic de Barcelona), Leopoldo Higa Sansone, Marta Blazquez Andion, Miriam Mateo Roca, Sergio A. Herrera Mateo (Hospital de Sant Pau de Barcelona), Sergio Pastor Marín, Elena del Carmen Sánchez Cánovas, Gaelia Bornas Cayuela, Alba Hernández Sánchez, José Andrés Sánchez Nicolás (Hospital Universitario Reína Sofía de Murcia), Esperanza Puga Montalvo, Ziad Issa-Masad Khozouz (Hospital Campus de la Salud de Granada), Katia Chávez Tafur, Yolanda Prieto Corredor, Consuelo Parra Carretero, Mercedes Elena Pina (Complejo Hospitalario Universitario de Albacete), Esther Maldonado Pérez, Rocío Garrido Rasco, Miguel Albarrán Núñez (Hospital Juan Ramón Jiménez de Huelva), Alicia Beteta López, Laura Janeth Duran Ducón, Sandra Verónica Tarabó Mieles, Ricardo Juárez González (Hospital Nuestra Señora del Prado de Talavera), Diana Moya Olmeda, María José Rodríguez Escudero (Hospital Virgen de la Luz de Cuenca), Belén Arribas Entrala (Hospital Universitario Miguel Servet de Zaragoza), Marta Honrado Fernández de Valderrama (Hospital Santiago Apóstol de Miranda de Ebro), Eva Quero Motto, Eva Mónico Castillo, Antonia Cantero Sandoval, Roxana Rojas Luán, María Jesús Huertas Sánchez (Hospital Virgen de la Arrixaca de Murcia), Agustín Arévalo Velasco, M. Jesús Bringas García, Ángel García García, Carmen Rivas Herrero, Sonia Del Amo Diego (Complejo Asistencial Universitario de Salamanca), Manel R. Chanovas-Borràs, Manuel Martínez Maimó, Noelia Cases Ariño, Carmen Melinda Prica, Montserrat Pech Solà (Hospital Verge de la Cinta de Tortosa), María Bóveda García, Jessica Mansilla Collado, Leticia Serrano Lázaro, Javier Millán Soria (Hospital La Fe de Valencia), Ángel Estella García, Mariola Aguilera Vidal, Mónica Carlota Aguilera Casasola, María del Mar Luque de Igunza, María Cristina Martín Rodríguez (Hospital Universitario de Jerez), Octavio José Salmerón Béliz, Ana Mecina Gutiérrez, Marta Beneyto Arana, Olivia Devora Ruano, Mª Mar Bermejo Olano (Hospital Universitario Fundación de Alcorcón), Guillermo Burillo Putze, Aarati Vaswani-Bouchald, Carmen Mercedes García-Pérez, Carmen de la Fuente-García, Jazael Santana Rodríguez (Hospital Universitario de Canarias), Ester Monclús Cols, María Jové Lázaro, David Pellejà Monné, María Mercedes Brea Álvarez (Hospital Sant Jaume de Calella de Barcelona),Marta Balaguer Catalán, Teresa López Fernández, Noelia Orts Saurí, Alberto Cercós Pérez, María Luisa López Grima (Hospital Universitario Doctor Peset de Valencia), Manuel Gil Mosquera, Luis Pérez Ordoño, Natalia Sánchez Prida, Laura Santos Franco, María Eugenia García Gil (Hospital Universitario 12 de octubre de Madrid), Ainhoa Urraca Gamaury, Marta Abeijón Vila, Carlos Aldasoro Frías (Complejo Asistencial de Zamora), Raúl López Izquierdo, Nieves Sobradillo Castrodeza (Hospital Universitario Río Hortega de Valladolid) Luis Quero Reboul (Hospital Virgen de la Merced de Osuna), Agurtzane Auzmendi Aguirre (Hospital de Mendaro de Gipuzkoa), Federico Melgosa Latorre, Fernando Abadia Cebrian, Ainhoa Albizuri Bernaola (Hospital de Alto Deba de Arrasate), Francisco José Ezponda Inchauspe, Ana María Iturzaeta Gorrotxategi (Hospital de Zumárraga), Pilar Jiménez (Hospital de Antequera), Josefina Monedero La Orden, Fernando Constantino Briones Monteagudo, Luis Miguel Cruz Ramírez (Hospital de Almansa), Ariel Rubén Lindo Noriega, Miguel Ángel Callejas Montoya, Gonzalo Fuentes Rodríguez (Hospital de Villarrobledo), Marta Iglesias Vela, Susana García Escudero, Nuria Álvarez Díez (Complejo Asistencial Universitario de León), Inmaculada Adán Valero, Pilar Yagüe Gómez, Jorge Eduardo Toledo Toledo (Hospital de Valdepeñas), Belén Rodríguez (Hospital Universitario Rey Juan Carlos), Francisco J Aramburu, Oscar Pérez Carral, Natalia Catherine Franco Zárate (Complejo Hospitalario Universitario de Ourense), Bárbara Díaz García, María José del Río Paz, Sonia Beatriz Rodríguez Martínez (Hospital de Barbanza), Virginia Álvarez Rodríguez, Eduardo Manzone, Rodolfo Romero Pareja (Hospital Universitario de Getafe), Ángel José Macías López, Antón Trigo González, Ángel Francisco Viola Candela (Complejo Asistencial de Ávila), María Debán Fernández, Pablo Herrero Puente (Hospital Central de Asturias), Fernando Rodríguez Pérez-Reverte, Ascensión Martínez Más, Sofía Martínez Saldumbide (Hospital Universitario Santa Lucía de Cartagena en Murcia), Neus Robert, Adrià Mendoza, Arantzazu Blanco (Hospital de Can Ruti), Silvia Flores Quesada, Osvaldo Troiano Ungerer (Hospital San Pau i Santa Tecla de Tarragona), Rosa García García, Fátima González Jiménez, Sara Moreno Suarez (Hospital Virgen de las Nieves de Granada), Raquel Rodríguez Calveiro, Inés López Fernández (Hospital Alvaro Cunqueiro de Vigo), Manuel García Novio, Teresa Pajares Vázquez (Hospital Universitario Lucus Augusti de Lugo), Laura González González (Hospital del Salnes de Vilagarcía de Arousa), Elena Carrasco Fernández (Hospital Virgen De Altagracia de Manzanares), María Pilar Lozano García, Daniela Mihaela Comaneci (Hospital Universitario de Guadalajara), Rigoberto Del Rio Navarro, Guillermo Moreno Montes (Hospital de Torrevieja), Elizabeth Ortiz García (Hospital Santa Bárbara de Soria), Leopoldo Sánchez Santos (Hospital Universitario de Burgos), Rosario Peinado (Hospital Infanta Cristina de Badajoz), Beatriz Valle Borrego (Hospital Severo Ochoa de Leganés), Pablo Javier Marchena Yglesias (Parc Sanitari Sant Joan de Déu de Sant Boi de Llobregat), Cristina Herranz Martínez (Hospital de Viladecans de Barcelona), Núria Pomares, Xavier López Altimirias (Fundació Hospital de Mollet), Sara Gayoso Martín (Hospital Comarcal Universitario El Escorial), Patricia Gutiérrez García (Hospital Comarcal de Medina del Campo), Marco Bustamante ( Hospital General de Granollers), Coral Suero Méndez (Hospital de la Axarquía de Vélez-Málaga), María García-Uría Santos (Clínica Universitaria de Navarra de Madrid), José Gregorio Zorrilla Riveiro (Hospital Sant Joan de Déu de Manresa), María Ángeles Leciñena (Hospital Can Mises de Ibiza), Antonio Duarte (Hospital de Torrecardenas de Almería), Carmen del Arco Galán (Hospital de la Princesa de Madrid).

Funding

This study received no financial support. The promoter of this study was the Infectious Disease Group of the Spanish Emergency Medicine Society. This group received financial support from Merck, Tedec-Meiji, Thermo Fisher, ViroGates and GSK in the last year to organise conferences and group meetings. None of the authors has received any financial compensation.

Author information

Authors and Affiliations

  1. Emergency Department, Complejo Hospitalario Universitario de Toledo, Universidad de Castilla La Mancha, Toledo, Spain

    Agustín Julián-Jiménez & Rafael Rubio Díaz

  2. Emergency Department, Hospital Universitario Clínico San Carlos, Calle Profesor Martín Lagos Calle Profesor Martín Lagos, 28040, Madrid, Spain

    Juan González del Castillo, Eric Jorge García-Lamberechts & Francisco Javier Martín-Sánchez

  3. Health Research Institute (IdISSC), Hospital Universitario San Carlos, Madrid, Spain

    Juan González del Castillo, Eric Jorge García-Lamberechts & Francisco Javier Martín-Sánchez

  4. Emergency Department, Hospital Universitario de Donostia, San Sebastian, Spain

    Itziar Huarte Sanz

  5. Emergency Department, Hospital Universitario Virgen de La Macarena, Sevilla, Spain

    Carmen Navarro Bustos

  6. Emergency Department, Hospital Universitario Sant Pau, Barcelona, Spain

    Josep María Guardiola Tey

  7. Emergency Department, Hospital Universitario de Bellvitge, Barcelona, Spain

    Ferrán Llopis-Roca

  8. Emergency Department, Hospital Universitario Reina Sofía, Murcia, Spain

    Pascual Piñera Salmerón

  9. Emergency Department, Hospital Universitario de Basurto, Bilbao, Spain

    Mikel de Martín-Ortiz de Zarate

  10. Emergency Department, Hospital Universitario Rio Hortega, Valladolid, Spain

    Jesús Álvarez-Manzanares

  11. Emergency Department, Hospital Universitario de Galdakao-Usansolo, Bizkaia, Spain

    Julio Javier Gamazo-Del Rio

  12. Emergency Department, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain

    Marta Álvarez Alonso

  13. Emergency Department, Hospital Virgen de La Victoria, Málaga, Spain

    Begoña Mora Ordoñez

  14. Emergency Department, Hospital Universitario de Móstoles, Madrid, Spain

    Oscar Álvarez López

  15. Emergency Department, Hospital Clínic, Barcelona, Spain

    María del Mar Ortega Romero

  16. Emergency Department, Hospital Nuestra Señora del Prado, Talavera de La Reina, Spain

    María del Mar Sousa Reviriego

  17. Emergency Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain

    Ramón Perales Pardo

  18. Emergency Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela , Spain

    Henrique Villena García del Real

  19. Emergency Department, Hospital Juan Ramón Jiménez de Huelva, Huelva, Spain

    María José Marchena González

  20. Emergency Department, Hospital Clínico Universitario Lozano Blesa de Zaragoza, Zaragoza, Spain

    José María Ferreras Amez

  21. Emergency Department, Hospital Virgen de La Luz de Cuenca, Cuenca, Spain

    Félix González Martínez

  22. Research Unit, Complejo Hospitalario Universitario de Toledo, Toledo, Spain

    Pedro Beneyto Martín

  23. Clinical Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain

    Francisco Javier Candel González

  24. Biomedical Technology Center - E.T.S. of Computer Engineers, Universidad Politécnica de Madrid, Madrid, Spain

    Antonio Jesús Díaz-Honrubia

Authors
  1. Agustín Julián-Jiménez
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  2. Juan González del Castillo
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  3. Eric Jorge García-Lamberechts
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  4. Itziar Huarte Sanz
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  5. Carmen Navarro Bustos
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  6. Rafael Rubio Díaz
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  7. Josep María Guardiola Tey
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  8. Ferrán Llopis-Roca
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  9. Pascual Piñera Salmerón
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  10. Mikel de Martín-Ortiz de Zarate
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  11. Jesús Álvarez-Manzanares
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  12. Julio Javier Gamazo-Del Rio
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  13. Marta Álvarez Alonso
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  14. Begoña Mora Ordoñez
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  15. Oscar Álvarez López
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  16. María del Mar Ortega Romero
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  17. María del Mar Sousa Reviriego
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  18. Ramón Perales Pardo
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  19. Henrique Villena García del Real
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  20. María José Marchena González
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  21. José María Ferreras Amez
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  22. Félix González Martínez
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  24. Pedro Beneyto Martín
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Consortia

on behalf of the INFURG-SEMES investigators

  • Esperanza Ansa Arlegui
  • , Igor Gallastegi Ruiz de Egino
  • , Ricardo Palenzuela Arozena
  • , Nerea Sarriegi Gorrotxategi
  • , Xabier Errazkin Telletxea
  • , Laura Munguía Nieva
  • , Diego Vicente Anza
  • , Maitane Arrastia Erviti
  • , Isabel Nieto Rojas
  • , William Esnaider López Forero
  • , Elena Sánchez Maganto
  • , Raúl Canabal Berlanga
  • , Isabel María Morales Barroso
  • , María Carmen Manzano Alba
  • , Fernando Oltra Hostalet
  • , José Gallardo Bautista
  • , María Angustias Sevilla Espejo
  • , María Jesús Domínguez García
  • , María Eugenia Barrero Ramos
  • , Cristina Latorre Marco
  • , Gema Delgado Cárdenas
  • , Alberto Sánchez Bernal
  • , Ángela Flores Palacio
  • , Laura Martínez Vega
  • , Laura Pérez Calero
  • , Teresa Rincón Sánchez
  • , M. Lourdes Nieto de Haro
  • , Jerónimo Amores Fernández
  • , Pablo Jerez-Fernández
  • , Miguel Suarez-Robles
  • , Clara Ramos-Rey
  • , Ines Armenteros Yeguas
  • , María Fernández-Revaldería
  • , Eva Orviz García
  • , Silvia Álvarez Kailis
  • , Beatriz Paderne Díaz
  • , Gema María Gómez García
  • , Alicia Rodríguez Urgel
  • , Sebastià Quetglas Roselló
  • , Manel Tuells Morales
  • , Marta Maristany Bosch
  • , Ana Badía Tejero
  • , Idoia Madariaga Ordeñana
  • , Ainhoa Burzako Sánchez
  • , Omar Saavedra
  • , Nuria Seguí
  • , Leticia Fresco
  • , Gina Osorio
  • , Julia Calvo
  • , Joan Ribot
  • , Irene Carbonell
  • , Leopoldo Higa Sansone
  • , Marta Blazquez Andion
  • , Miriam Mateo Roca
  • , Sergio A. Herrera Mateo
  • , Sergio Pastor Marín
  • , Elena del Carmen Sánchez Cánovas
  • , Gaelia Bornas Cayuela
  • , Alba Hernández Sánchez
  • , José Andrés Sánchez Nicolás
  • , Esperanza Puga Montalvo
  • , Ziad Issa-Masad Khozouz
  • , Katia Chávez Tafur
  • , Yolanda Prieto Corredor
  • , Consuelo Parra Carretero
  • , Mercedes Elena Pina
  • , Esther Maldonado Pérez
  • , Rocío Garrido Rasco
  • , Miguel Albarrán Núñez, Alicia Beteta López Laura Janeth Duran Ducón
  • , Sandra Verónica Tarabó Mieles
  • , Ricardo Juárez González
  • , Diana Moya Olmeda
  • , María José Rodríguez Escudero
  • , Belén Arribas Entrala
  • , Marta Honrado Fernández de Valderrama
  • , Eva Quero Motto
  • , Eva Mónico Castillo
  • , Antonia Cantero Sandoval
  • , Roxana Rojas Luán
  • , María Jesús Huertas Sánchez
  • , Agustín Arévalo Velasco
  • , M. Jesús Bringas García
  • , Ángel García García
  • , Carmen Rivas Herrero
  • , Sonia Del Amo Diego
  • , Manel R. Chanovas-Borràs
  • , Manuel Martínez Maimó
  • , Noelia Cases Ariño
  • , Carmen Melinda Prica
  • , Montserrat Pech Solà
  • , María Bóveda García
  • , Jessica Mansilla Collado
  • , Leticia Serrano Lázaro
  • , Javier Millán Soria
  • , Ángel Estella García
  • , Mariola Aguilera Vidal
  • , Mónica Carlota Aguilera Casasola
  • , María delde Mar LuqueIgunza
  • , María Cristina Martín Rodríguez
  • , Octavio José Salmerón Béliz
  • , Ana Mecina Gutiérrez
  • , Marta Beneyto Arana
  • , Olivia Devora Ruano
  • , Mª Mar Bermejo Olano
  • , Guillermo Burillo Putze
  • , Aarati Vaswani-Bouchald
  • , Carmen Mercedes García-Pérez
  • , Carmen de la Fuente-García
  • , Jazael Santana Rodríguez
  • , Ester Monclús Cols
  • , María Jové Lázaro
  • , David Pellejà Monné
  • , María Mercedes Brea Álvarez
  • , Marta Balaguer Catalán
  • , Teresa López Fernández
  • , Noelia Orts Saurí
  • , Alberto Cercós Pérez
  • , María Luisa López Grima
  • , Manuel Gil Mosquera
  • , Luis Pérez Ordoño
  • , Natalia Sánchez Prida
  • , Laura Santos Franco
  • , María Eugenia García Gil
  • , Ainhoa Urraca Gamaury
  • , Marta Abeijón Vila
  • , Carlos Aldasoro Frías
  • , Raúl López Izquierdo
  • , Nieves Sobradillo Castrodeza
  • , Luis Quero Reboul
  • , Agurtzane Auzmendi Aguirre
  • , Federico Melgosa Latorre
  • , Fernando Abadia Cebrian
  • , Ainhoa Albizuri Bernaola
  • , Francisco José Ezponda Inchauspe
  • , Ana María Iturzaeta Gorrotxategi
  • , Pilar Jiménez
  • , Josefina Monedero La Orden, Fernando Constantino Briones Monteagudo Luis Miguel Cruz Ramírez
  • , Ariel Rubén Lindo Noriega
  • , Miguel Ángel Callejas Montoya
  • , Gonzalo Fuentes Rodríguez
  • , Marta Iglesias Vela
  • , Susana García Escudero
  • , Nuria Álvarez Díez
  • , Inmaculada Adán Valero
  • , Pilar Yagüe Gómez
  • , Jorge Eduardo Toledo Toledo
  • , Belén Rodríguez
  • , Francisco J. Aramburu
  • , Oscar Pérez Carral
  • , Natalia Catherine Franco Zárate
  • , Bárbara Díaz García
  • , María José del Río Paz
  • , Sonia Beatriz Rodríguez Martínez
  • , Virginia Álvarez Rodríguez
  • , Eduardo Manzone
  • , Rodolfo Romero Pareja
  • , Ángel José Macías López
  • , Antón Trigo González
  • , Ángel Francisco Viola Candela
  • , María Debán Fernández
  • , Pablo Herrero Puente
  • , Fernando Rodríguez Pérez-Reverte
  • , Ascensión Martínez Más
  • , Sofía Martínez Saldumbide
  • , Neus Robert
  • , Adrià Mendoza
  • , Arantzazu Blanco
  • , Silvia Flores Quesada
  • , Osvaldo Troiano Ungerer
  • , Rosa García García
  • , Fátima González Jiménez
  • , Sara Moreno Suarez
  • , Raquel Rodríguez Calveiro
  • , Inés López Fernández, Manuel García Novio Teresa Pajares Vázquez
  • , Laura González González
  • , Elena Carrasco Fernández
  • , María Pilar Lozano García
  • , Daniela Mihaela Comaneci
  • , Rigoberto Del Rio Navarro
  • , Guillermo Moreno Montes
  • , Elizabeth Ortiz García
  • , Leopoldo Sánchez Santos
  • , Rosario Peinado
  • , Beatriz Valle Borrego
  • , Pablo Javier Marchena Yglesias
  • , Cristina Herranz Martínez
  • , Núria Pomares
  • , Xavier López Altimirias
  • , Sara Gayoso Martín
  • , Patricia Gutiérrez García
  • , Marco Bustamante
  • , Coral Suero Méndez
  • , María García-Uría Santos
  • , José Gregorio Zorrilla Riveiro
  • , María Ángeles Leciñena
  • , Antonio Duarte
  •  & Carmen del Arco Galán

Contributions

All authors contributed to the development of the study protocol. AJJ and JGC: planned the study concept and design. AJJ: obtained ethics committee approval and supervised the study. The other authors and members of the Infectious Disease Group of the Spanish Emergency Medicine Society collected all the data. AJJ and JGC: analysed and interpreted the data. PBM and FJMS: provided statistical advice. AJJ and JGC: prepared the first draft of the manuscript. All authors contributed to manuscript revision and all approved the final document.

Corresponding author

Correspondence to Juan González del Castillo.

Ethics declarations

Conflict of interest

All authors reported no conflicts of interest.

Ethical approval

The Ethical Committee of the Complejo Hospitalario Universitario de Toledo approved the study, as well as by the ethics board of each hospital where necessary. All patients were enrolled in accordance with the Helsinki declaration.

Consent for publication

No individual participant data is reported that would require consent to publish from the participant (or legal parent or guardian for children).

Additional information

Complete author detail of INFURG-SEMES investigators has been given in Acknowledgements.

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Julián-Jiménez, A., González del Castillo, J., García-Lamberechts, E.J. et al. A bacteraemia risk prediction model: development and validation in an emergency medicine population. Infection 50, 203–221 (2022). https://doi.org/10.1007/s15010-021-01686-7

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  • DOI: https://doi.org/10.1007/s15010-021-01686-7

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