Clinical Prediction Score for Community-Onset Bloodstream Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella Species
10.3346/jkms.2019.34.e116
- Author:
Moonsuk KIM
1
;
Kyoung Ho SONG
;
Chung Jong KIM
;
Pyoeng Gyun CHOE
;
Wan Beom PARK
;
Ji Hwan BANG
;
Eu Suk KIM
;
Sang Won PARK
;
Nam Joong KIM
;
Myoung don OH
;
Hong Bin KIM
Author Information
1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. khsongmd@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Prediction Score;
Community-Onset Infection;
Bloodstream Infection;
Extended-Spectrum Beta-Lactamase;
Escherichia coli;
Klebsiella
- MeSH:
Area Under Curve;
beta-Lactamases;
Cohort Studies;
Escherichia coli;
Escherichia;
Hospitalization;
Klebsiella;
Logistic Models;
Urinary Catheters
- From:Journal of Korean Medical Science
2019;34(14):e116-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: This study aimed to identify the predictors and build a prediction score for community-onset bloodstream infections (CO-BSIs) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella species. METHODS: All CO-BSIs caused by E. coli and Klebsiella species from 2012 to 2015 were grouped into derivation (BSIs from 2012 to 2014) and validation (BSIs in 2015) cohorts. A prediction score was built using the coefficients of the multivariate logistic regression model from the derivation cohort. RESULTS: The study included 886 CO-BSIs (594 and 292 in the derivation and validation cohorts, respectively). The independent predictors of CO-BSIs caused by ESBL-producing E. coli and Klebsiella species included: 1) identification of ESBL-producing microorganisms from any clinical culture within one year of admission, 2) beta-lactam or fluoroquinolone treatment within 30 days (with 2 or more courses within 90 days; with 1 course within 90 days), 3) hospitalization within one year, 4) the presence of an indwelling urinary catheter at the time of admission. The area under the curve (AUC) of the clinical prediction score was 0.72 (95% confidence interval [CI], 0.68–0.77). In the validation cohort, the AUC was 0.70 (95% CI, 0.63–0.77). CONCLUSIONS: The results of this study suggest a simple and easy-to-use scoring system to predict CO-BSIs caused by ESBL-producing E. coli and Klebsiella species.
