ArticleThe Journal of antimicrobial chemotherapy2025
A scoring system to predict resistance to ceftolozane/tazobactam in respiratory isolates of Pseudomonas aeruginosa.
Article in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Development and Validation of a Nomogram for Predicting Multidrug-ResistantInfection and drug resistance · 2025Article
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7 authors.
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Abstract
objectivesTo develop a scoring system to predict resistance to ceftolozane/tazobactam in Pseudomonas aeruginosa strains isolated from respiratory specimens.
methodsA case-control study was conducted to evaluate the risk factors associated with resistance to ceftolozane/tazobactam. Patients with P. aeruginosa were defined as cases if they had ceftolozane/tazobactam-resistant strains, whereas those with ceftolozane/tazobactam-susceptible strains were defined as test-negative controls. A predictive scoring system based on binary logistic regression coefficients was formulated to predict resistance to ceftolozane/tazobactam. The score's performance was assessed using ROC curves and AUC. The sensitivity, specificity and predictive values of the score were determined on the basis of a cut-off point, using the Youden index.
resultsCeftolozane/tazobactam resistance was detected in 18.4% of P. aeruginosa isolates from 473 patients. In multivariate analysis, a history of bronchoscopy [OR (95% CI) = 2.1 (1.1-4.3), P = 0.035], invasive mechanical ventilation [OR (95% CI) = 2.4 (1.2-4.5), P = 0.009], colistin/polymyxin B use [OR (95% CI) = 3.2 (1.8-5.7), P < 0.001] and fluoroquinolone use [OR (95% CI) = 2.3 (1.1-4.8), P = 0.024] in the preceding month prior to P. aeruginosa isolation were significantly associated with ceftolozane/tazobactam resistance. The AUC (95% CI) of the score was 0.734 (0.675-0.794), with a sensitivity of 69%, specificity of 71.8%, positive predictive value of 35.5% and negative predictive value of 91.1% at the cut-off point of 2, out of a range of 0-5.
conclusionsIn respiratory tract infections caused by P. aeruginosa, use of the proposed scoring system may reduce inappropriate use of ceftolozane/tazobactam in empirical treatment.
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