开发一个风险预测模型,以后的感染后殖民与carbapenem耐药 Enterobacterales:一个回顾性队列研究
Guanhao Zheng1, Jiaqi Cai2,3, Han Deng4
1World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China.
Antimicrobial resistance and infection control
|April 24, 2024
概括
这项研究开发了一种名谱,用于预测在被卡巴耐药肠道细菌 (CRE) 殖民的患者中感染风险. 该模型有助于早期识别高风险的CRE携带者,可能降低发病率和死亡率.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 流行病学 流行病学
背景情况:
- 耐卡巴胺肠道细菌 (CRE) 的殖民是感染的关键前体,与显著的发病率和死亡率有关.
- 准确预测CRE携带者的感染风险对于有效的临床管理至关重要.
研究的目的:
- 开发和验证一种预测模型,用于识别患有CRE殖民的患者,这些患者患上后续感染的风险很高.
- 建立一个预测30天和60天CRE殖民感染风险的诺米克图.
主要方法:
- 一项回顾性队列研究,涉及两家中国三级医院 (2011-2021) 的879名CRE殖民患者.
- 单变量分析和细灰子分布危险模型被用来确定CRE殖民感染的预测因素,死亡作为一个竞争事件.
- 为预测感染风险,构建并内部验证了一个名图.
主要成果:
- 196名 (25.8%) 患者随后发生了CRE感染,殖民后的中位时间为20天.
- 确定的关键预测因素包括多站点/多微生物殖民,导管,白蛋白使用,呼吸系统疾病,以及先前使用卡巴尼姆/组合抗生素.
- 诺米图显示可接受的歧视 (AUC 74.7%培训,81.1%验证) 和校准预测60天感染风险.
结论:
- 开发的诺米图表显示了对高风险CRE载体的早期识别的良好预测性能.
- 这种工具可以帮助临床医生积极管理被CRE定居的患者.
- 建议进行外部验证,以进一步确认模型的通用性.
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