Abstract
Bacteremia is a serious infection associated with high mortality rate. The diagnosis of bacteremia
depended on blood cultures. Published guidelines do not clearly state when blood cultures should be
obtained. The objectives of this study are to validate two clinical predictor rules: systematic inflammatory
response syndrome (SIRS) criteria and clinical prediction rule of Shapiro et al. for patients who were
suspicious of bacteremia. This study was retrospective cohort study, collected data from patients who
were suspicious of bacteremia in emergency department of Warinchamrab Hospital, Ubon Ratchathani. There were 457 patients met inclusion criteria, 65 patients (14%) whose blood cultures results were positive
for true pathogens. When applied SIRS criteria, the sensitivity and specificity were 83% and 31%
respectively. Positive likelihood ratio and negative likelihood ratio were 1.21 (95% confidence interval
1.06-1.38) and 0.54 (95% CI 0.31-0.93) respectively while applying clinical prediction rule of Shapiro et al.,
the sensitivity and specificity were 91% and 40%, respectively. Positive likelihood ratio and negative likelihood
ratio were 1.52 (95% CI 1.36-1.70) and 0.23 (95% CI 0.10-0.49), respectively. In conclusion clinical
prediction rule of Shapiro et al. is more accurate in predicting patients suspicious of bacteremia. Application
of this tool in clinical practice may reduce costs and improve quality of treatment.
