Clinical scoring model for predicting cefotaxime-resistance in Klebsiella pneumoniae bacteremia: development and validation based on portal of entry.

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES Journal of Chemotherapy Pub Date : 2024-05-23 DOI:10.1080/1120009X.2024.2357052

Hyoung-Tae Kim, Cheon-Hoo Jeon, Si-Ho Kim, Yu Mi Wi

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Abstract

We developed a prediction model for cefotaxime resistance in patients with K. pneumoniae bacteremia. Adult patients with K. pneumoniae bacteremia were grouped into derivation (from March 2018 to December 2019) and validation (from January 2020 to August 2020) cohorts. The prediction scoring system was based on factors associated with cefotaxime resistance identified by the logistic regression model. A total of 358 patients were enrolled (256 for derivation, 102 for validation). In the multivariable analysis, age ≥65 years, hospital-acquired infection, prior antimicrobial use, and an updated Charlson comorbidity index ≥3 points were associated with cefotaxime resistance in the derivation cohort. When each variable was counted as 1 point, the values of the area under the curve were 0.761 in the derivation and 0.781 in the validation cohorts. The best cutoff value using the Youden index was ≥2 with 73.6% sensitivity and 67.5% specificity. Our simple scoring system favorably predicted cefotaxime resistance.

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预测肺炎克雷伯菌菌血症中头孢他啶耐药性的临床评分模型：基于入口的开发和验证。

我们建立了肺炎克雷伯菌血症患者头孢他啶耐药性预测模型。肺炎克氏菌菌血症成人患者被分为衍生队列（2018 年 3 月至 2019 年 12 月）和验证队列（2020 年 1 月至 2020 年 8 月）。预测评分系统基于逻辑回归模型确定的头孢他啶耐药性相关因素。共有358名患者入选（256名入选推导组，102名入选验证组）。在多变量分析中，在推导队列中，年龄≥65岁、医院感染、既往使用过抗菌药物以及最新的Charlson合并症指数≥3点与头孢他啶耐药性有关。当每个变量都计为 1 点时，衍生队列和验证队列的曲线下面积值分别为 0.761 和 0.781。尤登指数的最佳临界值为≥2，灵敏度为73.6%，特异度为67.5%。我们的简单评分系统可以预测头孢他啶的耐药性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Chemotherapy 医学-药学

CiteScore

3.70

自引率

0.00%

发文量

144

审稿时长

6-12 weeks

期刊介绍： The Journal of Chemotherapy is an international multidisciplinary journal committed to the rapid publication of high quality, peer-reviewed, original research on all aspects of antimicrobial and antitumor chemotherapy. The Journal publishes original experimental and clinical research articles, state-of-the-art reviews, brief communications and letters on all aspects of chemotherapy, providing coverage of the pathogenesis, diagnosis, treatment, and control of infection, as well as the use of anticancer and immunomodulating drugs. Specific areas of focus include, but are not limited to: · Antibacterial, antiviral, antifungal, antiparasitic, and antiprotozoal agents; · Anticancer classical and targeted chemotherapeutic agents, biological agents, hormonal drugs, immunomodulatory drugs, cell therapy and gene therapy; · Pharmacokinetic and pharmacodynamic properties of antimicrobial and anticancer agents; · The efficacy, safety and toxicology profiles of antimicrobial and anticancer drugs; · Drug interactions in single or combined applications; · Drug resistance to antimicrobial and anticancer drugs; · Research and development of novel antimicrobial and anticancer drugs, including preclinical, translational and clinical research; · Biomarkers of sensitivity and/or resistance for antimicrobial and anticancer drugs; · Pharmacogenetics and pharmacogenomics; · Precision medicine in infectious disease therapy and in cancer therapy; · Pharmacoeconomics of antimicrobial and anticancer therapies and the implications to patients, health services, and the pharmaceutical industry.