ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2025
Identification and validation of a risk assessment scoring tool for extended-spectrum beta-lactamase-producing Enterobacterales bacteremia at a tertiary teaching hospital.
Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To identify institution-specific risk factors for extended-spectrum beta-lactamase (ESBL) bloodstream infections (BSI) to develop and validate a risk assessment scoring tool that can be utilized for hospitalized patients. Design: Single-center, retrospective, case-control study. Setting: Tertiary teaching hospital. Patients: Hospitalized adult and pediatric patients with Methods: Multivariable logistic regression assessed predictors of ESBL in a derivation cohort. Predictors were applied to a novel validation BSI cohort using area under the receiver-operator characteristics curve (ROC AUC) to assess the reliability of identifying patients likely to harbor ESBL at the time of organism identification. Results: A total of 238 patients in the derivation cohort met inclusion criteria stratified as ESBL (n = 68) or non-ESBL (n = 170). Multivariable logistic regression demonstrated diabetes, 30-day history of invasive procedure or antibiotic use, and/or history of ESBL as independent predictors of ESBL. After creation of an ESBL risk assessment tool, the results were applied to a validation cohort of 170 patients. This model displayed good calibration and discrimination with a strong predictive power (Hosmer-Lemeshow χ Conclusions: A validated ESBL risk assessment tool reliably identified hospitalized patients likely to harbor ESBL
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