Authors
Dewi Kartika Turbawaty ^1,2, Levina Felicia¹, Ratu Purwanti^1,2

Affiliations

¹Department of Clinical Pathology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia; ²Department of Supporting Medicine, Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia

Background

• Bacteremia can progress to sepsis and organ failure if not treated promptly.

• Blood culture is the gold standard but slow, often negative, and prone to false positives.

Methods

• Retrospective single-center cross-sectional study of adult ED patients at Dr. Hasan Sadikin General Hospital (May 2023–July 2025).

• Compared the Shapiro Decision Rule (SDR), SIRI, and SII in 481 patients (111 with confirmed bacteremia).

Key Results

• SDR had the best discrimination (sensitivity 87.4%, AUC 0.696).

• It outperformed SIRI (AUC 0.601) and SII (AUC 0.508).

• SDR remained an independent predictor of bacteremia after adjustment.

Discussion & Conclusion

• SDR is significantly better than SIRI and SII at predicting bacteremia, with moderate discrimination.

• It can serve as a practical exclusion tool to help rationalize blood-culture requests in the emergency department.

Related SDGs

SDG 3: Good Health and Well-Being – Improving rapid detection of serious infection

Journal Information

Journal: Infection and Drug Resistance

DOI: https://doi.org/10.2147/IDR.S619432