Evidence map›Paper›PMID 36172877›Full record

ArticleInfection control and hospital epidemiology2023

Derivation and validation of a risk assessment model for drug-resistant pathogens in hospitalized patients with community-acquired pneumonia.

Michael B Rothberg, Sarah Haessler, Abhishek Deshpande, Pei-Chun Yu, Peter K Lindenauer, Marya D Zilberberg, Thomas L Higgins, Peter B Imrey

Open access · greenAbstract read
In one paragraph

Article in Infection control and hospital epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 32% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Risk factors for drug-resistant pathogens in community-acquired pneumonia: systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025
    Pooled it
  2. Review
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 4 institutions in 1 country.

Michael B RothbergCenter for Value-Based Care Research, Cleveland Clinic Community Care, Cleveland Clinic, Cleveland, Ohio.ORCID 0000-0002-2063-1876
Sarah HaesslerDivision of Infectious Diseases, University of Massachusetts Medical School - Baystate, Springfield, Massachusetts.
Abhishek DeshpandeCenter for Value-Based Care Research, Cleveland Clinic Community Care, Cleveland Clinic, Cleveland, Ohio.ORCID 0000-0001-5522-2995
Pei-Chun YuDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
Peter K LindenauerInstitute for Healthcare Delivery and Population Science and Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts.
Marya D ZilberbergUniversity of Massachusetts, Amherst, Massachusetts, and EviMed Research Group, Goshen, Massachusetts.ORCID 0000-0002-7266-9761
Thomas L HigginsDivision of Pulmonary and Critical Care Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts.ORCID 0000-0002-9958-0767
Peter B ImreyDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
Cleveland Clinic · USBaystate Medical Center · USUniversity of Massachusetts Amherst · USUniversity of Massachusetts Chan Medical School · US

Funding

Reducing Antimicrobial Overuse in HCAP Through Personalized Antimicrobial RecommendationsR01HS024277 · AHRQ · CLEVELAND CLINIC FOUNDATION · PI ROTHBERG, MICHAEL B · 2015 to 2019
$2.5M
AHRQ HHS R01 HS024277
6 · The paper itself

Abstract

objectiveTo derive and validate a model for risk of resistance to first-line community-acquired pneumonia (CAP) therapy.

designWe developed a logistic regression prediction model from a large multihospital discharge database and validated it versus the Drug Resistance in Pneumonia (DRIP) score in a holdout sample and another hospital system outside that database. Resistance to first-line CAP therapy (quinolone or third generation cephalosporin plus macrolide) was based on blood or respiratory cultures.

settingThis study was conducted using data from 177 Premier Healthcare database hospitals and 11 Cleveland Clinic hospitals.

participantsAdults hospitalized for CAP. EXPOSURE: Risk factors for resistant infection.

resultsAmong 138,762 eligible patients in the Premier database, 12,181 (8.8%) had positive cultures and 5,200 (3.8%) had organisms resistant to CAP therapy. Infection with a resistant organism in the previous year was the strongest predictor of resistance; markers of acute illness (eg, receipt of mechanical ventilation or vasopressors) and chronic illness (eg, pressure ulcer, paralysis) were also associated with resistant infections. Our model outperformed the DRIP score with a C-statistic of 0.71 versus 0.63 for the DRIP score (

conclusionsOur model predicting infection with a resistant pathogen outperformed both the DRIP score and physician practice in an external validation set. Its integration into practice could reduce unnecessary use of broad-spectrum antibiotics.

Indexed as

Community-Acquired InfectionsPneumoniaAdultAnti-Bacterial AgentsDrug Resistance, BacterialHumansRisk AssessmentAnti-Bacterial Agents

Identifiers

PMID36172877
PMCPMC10050215
OpenAlexW4297965574

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.