ArticleJournal of the Pediatric Infectious Diseases Society2020
A Decision Tree Using Patient Characteristics to Predict Resistance to Commonly Used Broad-Spectrum Antibiotics in Children With Gram-Negative Bloodstream Infections.
Article in Journal of the Pediatric Infectious Diseases Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 25 citations in OpenAlex.
- Precision navigation through the labyrinth: overcoming EGFR resistance in non-Small cell lung cancer.Annals of medicine · 2025Review
- Antimicrobial stewardship programs in a network of Canadian acute care hospitals: a cross-sectional survey.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Integrating sequencing methods with machine learning for antimicrobial susceptibility testing in pediatric infections: current advances and future insights.Frontiers in microbiology · 2025Review
- Dental Antimicrobial Stewardship: Developing a Mobile Application for Rational Antibiotic Prescribing to Tackle Misdiagnosis.Antibiotics (Basel, Switzerland) · 2024Article
- Increase in Incidence Rates and Risk Factors for Multidrug Resistant Bacteria in Septic Children: A Nationwide Spanish Cohort Study (2013-2019).Antibiotics (Basel, Switzerland) · 2023Article
- Carbapenem resistance in Enterobacterales bloodstream infections among children with cancer or post-haematopoietic stem cell transplant: a retrospective cohort study.The Journal of antimicrobial chemotherapy · 2023Article
- A novel strategy to characterize the pattern of β-lactam antibiotic-induced drug resistance in Acinetobacter baumannii.Scientific reports · 2023Article
- Using Machine Learning to Predict Antimicrobial Resistance-A Literature Review.Antibiotics (Basel, Switzerland) · 2023Review
- A novel strategy to characterize the pattern of β-lactam antibiotic-induced drug resistance in Acinetobacter baumannii.Research square · 2023Article
- Optimal Management of Complicated Infections in the Pediatric Patient: The Role and Utility of Ceftazidime/Avibactam.Infection and drug resistance · 2020Review
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAs rates of multidrug-resistant gram-negative infections rise, it is critical to recognize children at high risk of bloodstream infections with organisms resistant to commonly used empiric broad-spectrum antibiotics. The objective of the current study was to develop a user-friendly clinical decision aid to predict the risk of resistance to commonly prescribed broad-spectrum empiric antibiotics for children with gram-negative bloodstream infections.
methodsThis was a longitudinal retrospective cohort study of children with gram-negative bacteria cared for at a tertiary care pediatric hospital from June 2009 to June 2015. The primary outcome was a bloodstream infection due to bacteria resistant to broad-spectrum antibiotics (ie, cefepime, piperacillin-tazobactam, meropenem, or imipenem-cilastatin). Recursive partitioning was used to develop the decision tree.
resultsOf 689 episodes of gram-negative bloodstream infections included, 31% were resistant to broad-spectrum antibiotics. The decision tree stratified patients into high- or low-risk groups based on prior carbapenem treatment, a previous culture with a broad-spectrum antibiotic resistant gram-negative organism in the preceding 6 months, intestinal transplantation, age ≥3 years, and ≥7 prior episodes of gram-negative bloodstream infections. The sensitivity for classifying high-risk patients was 46%, and the specificity was 91%.
conclusionA decision tree offers a novel approach to individualize patients' risk of gram-negative bloodstream infections resistant to broad-spectrum antibiotics, distinguishing children who may warrant even broader antibiotic therapy (eg, combination therapy, newer β-lactam agents) from those for whom standard empiric antibiotic therapy is appropriate. The constructed tree needs to be validated more widely before incorporation into clinical practice.
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