Evidence map›Paper›PMID 33399979›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2021

Deep learning model for prediction of extended-spectrum beta-lactamase (ESBL) production in community-onset Enterobacteriaceae bacteraemia from a high ESBL prevalence multi-centre cohort.

Alfred Lok Hang Lee, Curtis Chun Kit To, Angus Lang Sun Lee, Ronald Cheong Kin Chan, Janus Siu Him Wong, Chun Wai Wong, Viola Chi Ying Chow, Raymond Wai Man Lai

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 3 pooled it
0.8field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Artificial intelligence in antimicrobial stewardship: a systematic review and meta-analysis of predictive performance and diagnostic accuracy.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Alfred Lok Hang LeeDepartment of Microbiology, Prince of Wales Hospital, Shatin, Hong Kong. leelh1107@gmail.com.ORCID http://orcid.org/0000-0002-2161-1420
Curtis Chun Kit ToDepartment of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Shatin, Hong Kong.
Angus Lang Sun LeeDepartment of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Shatin, Hong Kong.
Ronald Cheong Kin ChanDepartment of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Shatin, Hong Kong.
Janus Siu Him WongDepartment of Orthopaedics and Traumatology, University of Hong Kong, Pok Fu Lam, Hong Kong.
Chun Wai WongDepartment of Microbiology, Prince of Wales Hospital, Shatin, Hong Kong.
Viola Chi Ying ChowDepartment of Microbiology, Prince of Wales Hospital, Shatin, Hong Kong.
Raymond Wai Man LaiDepartment of Microbiology, Prince of Wales Hospital, Shatin, Hong Kong.
Chinese University of Hong Kong · HKPrince of Wales Hospital · CNUniversity of Hong Kong · HK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Adequate empirical antimicrobial coverage is instrumental in clinical management of community-onset Enterobacteriaceae bacteraemia in areas with high ESBL prevalence, while balancing the risk of carbapenem overuse and emergence of carbapenem-resistant organisms. It is unknown whether machine learning offers additional advantages to conventional statistical methods in prediction of ESBL production. To develop a validated model to predict ESBL production in Enterobacteriaceae causing community-onset bacteraemia. 5625 patients with community-onset bacteraemia caused by Escherichia coli, Klebsiella species and Proteus mirabilis during 1 January 2015-31 December 2019 from three regional hospitals in Hong Kong were included in the analysis, after exclusion of blood cultures obtained beyond 48 h of admission. The prevalence of ESBL-producing Enterobacteriaceae was 23.7% (1335/5625). Deep neural network and other machine learning algorithms were compared against conventional statistical model via multivariable logistic regression. Primary outcomes compared consisted of predictive model area under curve of receiver-operator characteristic curve (AUC), and macro-averaged F1 score. Secondary outcomes included sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Deep neural network yielded an AUC of 0.761 (95% CI 0.725-0.797) and F1 score of 0.661 (95% CI 0.633-0.689), which was superior to logistic regression (AUC 0.667 (95% CI 0.627-0.707), F1 score 0.596 (95% CI 0.567-0.625)). Deep neural network had a specificity of 91.5%, sensitivity of 37.5%, NPV of 82.5%, and PPV of 57.9%. Deep neural network is superior to logistic regression in predicting ESBL production in Enterobacteriaceae causing community-onset bacteraemia in high-ESBL prevalence area. Machine learning offers clinical utility in guiding judicious empirical antibiotics use.

Indexed as

Deep Learningbeta-LactamasesBlood CultureCohort StudiesCommunity-Acquired InfectionsEnterobacteriaceaeEnterobacteriaceae InfectionsHong KongHumansModels, BiologicalMultivariate Analysisbeta-Lactamases

Identifiers

PMID33399979
OpenAlexW3120422239

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.