Predicting bacteremia caused by Streptococcus anginosus group: A new scoring method.

ABSTRACT

BACKGROUND: Viridans group streptococci (VGS) are the most common causative organisms of infective endocarditis. Among VGS, the Streptococcus anginosus group (SAG) is often associated with abscess formation, and delayed diagnosis leads to increased morbidity and mortality. This study aims to examine the factors associated with SAG bacteremia and develop a predictive scoring method. METHODS: This single-center retrospective case-control study of patients with VGS bacteremia compared the background and clinical characteristics between the SAG and non-SAG groups. The univariate analysis used the χ2 test and t-test. The multivariate analysis was conducted using logistic regression. RESULTS: Out of 161 patients, 95 had SAG and 66 had non-SAG bacteremia. Age >63 years 2 points (odds ratio [OR] = 3.52, 95% confidence interval [CI] 1.64-7.54); solid tumor 2 points (OR = 4.44, 95% CI 1.42-6.77); C-reactive protein >7.61 mg/dL 3 points (OR = 5.40, 95% CI 2.49-11.72), and white blood cell count >8550/µL 2 points (OR = 2.76, 95% CI 1.29-2.91) were found to be independently associated with SAG bacteremia. After totaling the above variables and adding 1 point for diabetes mellitus, the area under the receiver operating curve was 0.81 (95% CI 0.74-0.88). The sensitivity and specificity were 51% and 88%, respectively, at a cut-off of 6 points. CONCLUSIONS: In patients with VGS bacteremia, a score of 6 points or higher using this method predicts SAG with high specificity.