Risk factors for positive culture of carbapenem-resistant Enterobacteriaceae in patients of critical care medicine department and establishment of prediction model
10.11816/cn.ni.2025-250321
- VernacularTitle:重症医学科患者耐碳青霉烯类肠杆菌科细菌阳性危险因素识别及预测模型构建
- Author:
Qingqing GUO
1
;
Chunlian ZHOU
1
Author Information
1. 首都医科大学附属北京友谊医院疾病控制与预防感染管理处,北京 100050
- Publication Type:Journal Article
- Keywords:
Carbapenem-resistant Enterobacteriaceae;
Infection;
Intensive care unit;
Risk factor;
Prediction model
- From:
Chinese Journal of Nosocomiology
2025;35(18):2806-2810
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze the risk factors for positive culture of carbapenem-resistant Enterobacteriaceae(CRE)in the intensive care unit(ICU)patients so as to provide scientific technical support for early identification of the patients at high-risk of CRE colonization/infection in clinical practice.METHODS The clinical data and bac-terial culture data were collected from the ICU patients who were hospitalized in Beijing Friendship Hospital from 2021 to 2023 so as to build up retrospective cohorts.The risk factors for positive culture of CRE in the ICU pa-tients were screened out with the use of multivariate logistic regression model,and the predictive effect of the model was evaluated by means of receiver operating characteristic(ROC)curves and Hosmer-Lemeshow test.RESULTS Gastric tube indwelling history(OR=3.992,95％CI:1.894 to 8.121),wards of patients detected with CRE within 7 days during the stay(OR=3.518,95％CI:1.492 to 8.294),renal disease history(OR=2.063,95％CI:1.128 to 3.775),history of isolation of multidrug-resistant organisms(OR=2.400,95％CI:1.240 to 4.647)and use of carbapenem antibiotics(OR=1.141,95％CI:1.088 to 1.196)were the independent risk fac-tors for the positive culture of CRE in the ICU patients.The prediction model that was established based on the risk factors showed favorable discrimination,and the area under the ROC curve(AUC)was 0.773.The actual probability was comparatively consistent with the ideal probability,with the Hosmer-Lemeshow test(x2=9.274,P=0.233).CONCLUSION The model shows remarkable effect on prediction of positive culture of CRE in the ICU patients,and it has high value in early identification of the patients at high risk of CRE colonization/infection in clinical practice.
