Development and validation of risk prediction model for carbapenem-resistant Klebsiella pneumoniae infection
- VernacularTitle:耐碳青霉烯类肺炎克雷伯菌感染风险预测模型的构建及验证
- Author:
Yinzhu MO
1
,
2
;
Xianxiong CHENG
1
,
2
;
Cangsang SONG
1
;
Shijie LYU
1
,
2
;
Baojun REN
3
;
Zhiwei LI
4
;
Jinying BAO
1
;
Huanzhi YANG
1
Author Information
1. Dept. of Pharmacy，Kunming First People’s Hospital，Kunming 650034，China
2. Dept. of Pharmacy，the Affiliated Ganmei Hospital of Kunming Medical University，Kunming 650034，China
3. Dept. of Clinical Laboratory，Kunming First People’s Hospital，Kunming 650034，China
4. Intensive Care Unit，Kunming First People’s Hospital，Kunming 650034，China
- Publication Type:Journal Article
- Keywords:
carbapenem-resistant Klebsiella pneumoniae;
risk factors;
nomogram;
predictive model
- From:
China Pharmacy
2025;36(14):1786-1791
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the independent risk factors for carbapenem-resistant Klebsiella pneumoniae （CRKP） infection， develop a nomogram prediction model and validate it. METHODS Clinical data of hospitalized patients infected with CRKP between April 2020 and May 2023 at Kunming First People’s Hospital were retrospectively collected and matched 1∶1 with patients infected with carbapenem-susceptible Klebsiella pneumoniae （CSKP） during the same period as the modeling group. Using the same criteria， data from patients hospitalized and infected with CRKP and matched CSKP between June 2023 and June 2024 were collected as the validation group. Univariate analysis， LASSO regression and multivariate Logistic regression were conducted to identify independent risk factors for CRKP infection and to develop a nomogram prediction model. Internal validation of the model was performed using Bootstrap resampling， and external validation was carried out using the data of validation group. The predictive performance of the model was evaluated using receiver operating characteristic （ROC） curves and calibration plots. RESULTS A total of 530 patients were enrolled， with 372 in the modeling group and 158 in the validation group. Cerebrovascular disease， indwelling gastric tube， mechanical ventilation， exposure to carbapenem antibiotics， and exposure to β-lactamase inhibitor compound agents were identified as independent risk factors for CRKP infection （P＜0.05）. The nomogram predicting CRKP infection risk achieved an area under ROC of 0.729 and 0.803 in internal and external validations， respectively. Calibration curves indicated a high degree of consistency between predicted and observed probabilities. CONCLUSIONS Cerebrovascular disease， indwelling gastric tube， mechanical ventilation， exposure to carbapenem antibiotics， and exposure to β-lactamase inhibitor compound agent are independent risk factors for CRKP infection. The developed nomogram model for predicting CRKP infection risk demonstrates good predictive performance and can aid in the early identification of patients at high risk for CRKP infection.
