Evidence map›Paper›PMID 38573310›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024

Development of Predictive Models to Inform a Novel Risk Categorization Framework for Antibiotic Resistance in Escherichia coli-Caused Uncomplicated Urinary Tract Infection.

Ryan K Shields, Wendy Y Cheng, Kalé Kponee-Shovein, Daniel Indacochea, Chi Gao, Fernando Kuwer, Ashish V Joshi, Fanny S Mitrani-Gold, Patrick Schwab, Diogo Ferrinho and 6 more

Open access · hybridAbstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.5field-weighted citation impact, top 18% 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, 4 citations in OpenAlex.

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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

16 authors at 4 institutions in 1 country.

Ryan K ShieldsDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID 0000-0001-9794-5665
Wendy Y ChengAnalysis Group, Inc., Boston, Massachusetts, USA.
Kalé Kponee-ShoveinAnalysis Group, Inc., Boston, Massachusetts, USA.
Daniel IndacocheaAnalysis Group, Inc., Boston, Massachusetts, USA.
Chi GaoAnalysis Group, Inc., Boston, Massachusetts, USA.
Fernando KuwerAnalysis Group, Inc., Boston, Massachusetts, USA.
Ashish V JoshiGSK, Collegeville, Pennsylvania, USA.
Fanny S Mitrani-GoldGSK, Collegeville, Pennsylvania, USA.
Patrick SchwabGSK, Collegeville, Pennsylvania, USA.
Diogo FerrinhoGSK, Collegeville, Pennsylvania, USA.
Malena MahendranAnalysis Group, Inc., Boston, Massachusetts, USA.
Lisa PinheiroAnalysis Group, Inc., Boston, Massachusetts, USA.
Jimmy RoyerAnalysis Group, Inc., Boston, Massachusetts, USA.
Madison T PreibGSK, Collegeville, Pennsylvania, USA.
Jennifer HanGSK, Collegeville, Pennsylvania, USA.
Richard ColganDepartment of Family Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Analysis Group (United States) · USGlaxoSmithKline (United States) · USUniversity of Maryland, Baltimore · USUniversity of Pittsburgh · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn clinical practice, challenges in identifying patients with uncomplicated urinary tract infections (uUTIs) at risk of antibiotic nonsusceptibility may lead to inappropriate prescribing and contribute to antibiotic resistance. We developed predictive models to quantify risk of nonsusceptibility to 4 commonly prescribed antibiotic classes for uUTI, identify predictors of nonsusceptibility to each class, and construct a corresponding risk categorization framework for nonsusceptibility.

methodsEligible females aged ≥12 years with Escherichia coli-caused uUTI were identified from Optum's de-identified Electronic Health Record dataset (1 October 2015-29 February 2020). Four predictive models were developed to predict nonsusceptibility to each antibiotic class and a risk categorization framework was developed to classify patients' isolates as low, moderate, and high risk of nonsusceptibility to each antibiotic class.

resultsPredictive models were developed among 87 487 patients. Key predictors of having a nonsusceptible isolate to ≥3 antibiotic classes included number of previous UTI episodes, prior β-lactam nonsusceptibility, prior fluoroquinolone treatment, Census Bureau region, and race. The risk categorization framework classified 8.1%, 14.4%, 17.4%, and 6.3% of patients as having isolates at high risk of nonsusceptibility to nitrofurantoin, trimethoprim-sulfamethoxazole, β-lactams, and fluoroquinolones, respectively. Across classes, the proportion of patients categorized as having high-risk isolates was 3- to 12-fold higher among patients with nonsusceptible isolates versus susceptible isolates.

conclusionsOur predictive models highlight factors that increase risk of nonsusceptibility to antibiotics for uUTIs, while the risk categorization framework contextualizes risk of nonsusceptibility to these treatments. Our findings provide valuable insight to clinicians treating uUTIs and may help inform empiric prescribing in this population.

Indexed as

Anti-Bacterial AgentsEscherichia coliEscherichia coli InfectionsUrinary Tract InfectionsAdolescentAdultAgedDrug Resistance, BacterialFemaleHumansMicrobial Sensitivity TestsMiddle AgedRisk AssessmentYoung AdultAnti-Bacterial Agentsantibiotic resistancefluoroquinolonepredictive modelingtrimethoprim-sulfamethoxazoleuncomplicated urinary tract infection

Identifiers

PMID38573310
PMCPMC11327794
OpenAlexW4393950307

What OpenQuestion holds

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LicenceCC BY
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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.