#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Utility of qSOFA and modified SOFA in severe malaria presenting as sepsis


Autoři: Prapit Teparrukkul aff001;  Viriya Hantrakun aff002;  Mallika Imwong aff002;  Nittaya Teerawattanasook aff004;  Gumphol Wongsuvan aff002;  Nicholas PJ. Day aff002;  Arjen M. Dondorp aff002;  T. Eoin West aff006;  Direk Limmathurotsakul aff002
Působiště autorů: Medical Department, Sunpasitthiprasong Hospital, Ubon Ratchthani, Thailand aff001;  Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand aff002;  Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand aff003;  Medical Technology Department, Sunpasitthiprasong Hospital, Ubon Ratchthani, Thailand aff004;  Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom aff005;  Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Washington, United States of America aff006;  Department of Global Health, University of Washington, Seattle, Washington, United states of America aff007;  Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand aff008
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223457

Souhrn

Sepsis can be caused by malaria infection, but little is known about the utility of the quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) and SOFA score in malaria. We conducted a prospective observational study from March 2013 to February 2017 to examine adults admitted with community-acquired infection in a tertiary-care hospital in Ubon Ratchathani, Northeast Thailand (Ubon-sepsis). Subjects were classified as having sepsis if they had a modified SOFA score ≥2 within 24 hours of admission. Serum was stored and later tested for malaria parasites using a nested PCR assay. Presence of severe malaria was defined using modified World Health Organization criteria. Of 4,989 patients enrolled, 153 patients (3%) were PCR positive for either Plasmodium falciparum (74 [48%]), P. vivax (69 [45%]), or both organisms (10 [7%]). Of 153 malaria patients, 80 were severe malaria patients presenting with sepsis, 70 were non-severe malaria patients presenting with sepsis, and three were non-severe malaria patients presenting without sepsis. The modified SOFA score (median 5; IQR 4–6; range 1–18) was strongly correlated with malaria severity determined by the number of World Health Organization severity criteria satisfied by the patient (Spearman’s rho = 0.61, p<0.001). Of 80 severe malaria patients, 2 (2.5%), 11 (14%), 62 (77.5%) and 5 (6%), presented with qSOFA scores of 0, 1, 2 and 3, respectively. Twenty eight-day mortality was 1.3% (2/153). In conclusion, qSOFA and SOFA can serve as markers of disease severity in adults with malarial sepsis. Patients presenting with a qSOFA score of 1 may also require careful evaluation for sepsis; including diagnosis of cause of infection, initiation of medical intervention, and consideration for referral as appropriate.

Klíčová slova:

Blood – Diagnostic medicine – Malaria – Nosocomial infections – Plasmodium – Respiratory infections – Sepsis – Nested polymerase chain reaction


Zdroje

1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–10. doi: 10.1001/jama.2016.0287 26903338

2. Rudd KE, Seymour CW, Aluisio AR, Augustin ME, Bagenda DS, Beane A, et al. 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. JAMA. 2018;319(21):2202–11. doi: 10.1001/jama.2018.6229 29800114

3. Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, et al. Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations. Am J Respir Crit Care Med. 2016;193(3):259–72. doi: 10.1164/rccm.201504-0781OC 26414292

4. Auma MA, Siedner MJ, Nyehangane D, Nalusaji A, Nakaye M, Mwanga-Amumpaire J, et al. Malaria is an uncommon cause of adult sepsis in south-western Uganda. Malar J. 2013;12:146. doi: 10.1186/1475-2875-12-146 23634654

5. WHO. World Malaria Report 2017. Available from: http://apps.who.int/iris/bitstream/handle/10665/259492/9789241565523-eng.pdf.

6. Plewes K, Turner GDH, Dondorp AM. Pathophysiology, clinical presentation, and treatment of coma and acute kidney injury complicating falciparum malaria. Curr Opin Infect Dis. 2018;31(1):69–77. doi: 10.1097/QCO.0000000000000419 29206655

7. Anstey NM, Russell B, Yeo TW, Price RN. The pathophysiology of vivax malaria. Trends Parasitol. 2009;25(5):220–7. doi: 10.1016/j.pt.2009.02.003 19349210

8. Hanson J, Phu NH, Hasan MU, Charunwatthana P, Plewes K, Maude RJ, et al. The clinical implications of thrombocytopenia in adults with severe falciparum malaria: a retrospective analysis. BMC Med. 2015;13:97. doi: 10.1186/s12916-015-0324-5 25907925

9. Hantrakun V, Somayaji R, Teparrukkul P, Boonsri C, Rudd K, Day NPJ, et al. Clinical epidemiology and outcomes of community acquired infection and sepsis among hospitalized patients in a resource limited setting in Northeast Thailand: A prospective observational study (Ubon-sepsis). PLoS One. 2018;13(9):e0204509. doi: 10.1371/journal.pone.0204509 30256845

10. World Bank. World Development Indicators. Available from: http://data.worldbank.org/data-catalog/world-development-indicators2013.

11. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39(2):165–228. doi: 10.1007/s00134-012-2769-8 23361625

12. Mulvaney SP, Fitzgerald LA, Hamdan LJ, Ringeisen BR, Petersen ER, Compton JR, et al. Rapid design and fielding of four diagnostic technologies in Sierra Leone, Thailand, Peru, and Australia: Successes and challenges faced introducing these biosensors. Sensing and Bio-Sensing Research. 2018;20:22–33. https://doi.org/10.1016/j.sbsr.2018.06.003.

13. Paris DH, Imwong M, Faiz AM, Hasan M, Yunus EB, Silamut K, et al. Loop-mediated isothermal PCR (LAMP) for the diagnosis of falciparum malaria. Am J Trop Med Hyg. 2007;77(5):972–6. 17984362

14. Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):762–74. doi: 10.1001/jama.2016.0288 26903335

15. Rutledge R, Lentz CW, Fakhry S, Hunt J. Appropriate use of the Glasgow Coma Scale in intubated patients: a linear regression prediction of the Glasgow verbal score from the Glasgow eye and motor scores. The Journal of trauma. 1996;41(3):514–22. doi: 10.1097/00005373-199609000-00022 8810973

16. Hanson J, Lee SJ, Mohanty S, Faiz MA, Anstey NM, Charunwatthana P, et al. A simple score to predict the outcome of severe malaria in adults. Clin Infect Dis. 2010;50(5):679–85. doi: 10.1086/649928 20105074

17. Hanson J, Lee SJ, Mohanty S, Faiz MA, Anstey NM, Price RN, et al. Rapid clinical assessment to facilitate the triage of adults with falciparum malaria, a retrospective analysis. PLoS One. 2014;9(1):e87020. doi: 10.1371/journal.pone.0087020 24489828

18. Newton PN, Stepniewska K, Dondorp A, Silamut K, Chierakul W, Krishna S, et al. Prognostic indicators in adults hospitalized with falciparum malaria in Western Thailand. Malar J. 2013;12:229. doi: 10.1186/1475-2875-12-229 23829311

19. Helbok R, Issifou S, Matsiegui PB, Lackner P, Missinou MA, Kombila D, et al. Simplified multi-organ dysfunction score predicts disability in African children with Plasmodium falciparum malaria. Am J Trop Med Hyg. 2006;75(3):443–7. 16968919.

20. Helbok R, Dent W, Nacher M, Treeprasertsuk S, Krudsood S, Wilairatana P, et al. Use of the multi-organ dysfunction score as a tool to discriminate different levels of severity in uncomplicated Plasmodium falciparum malaria. Am J Trop Med Hyg. 2003;68(3):372–5. 12685647

21. Rahimi BA, Thakkinstian A, White NJ, Sirivichayakul C, Dondorp AM, Chokejindachai W. Severe vivax malaria: a systematic review and meta-analysis of clinical studies since 1900. Malar J. 2014;13:481. doi: 10.1186/1475-2875-13-481 25486908

22. Imwong M, Jindakhad T, Kunasol C, Sutawong K, Vejakama P, Dondorp AM. An outbreak of artemisinin resistant falciparum malaria in Eastern Thailand. Sci Rep. 2015;5:17412. doi: 10.1038/srep17412 26616851


Článek vyšel v časopise

PLOS One


2019 Číslo 10
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#