中国药房2024，Vol.35Issue(1)：75-79,5.DOI:10.6039/j.issn.1001-0408.2024.01.13
碳青霉烯类耐药肺炎克雷伯菌致血流感染风险预测模型的构建
Construction of a risk prediction model for bloodstream infection induced by carbapenem-resistant Klebsiella pneumoniae
摘要
Abstract
OBJECTIVE To construct a risk prediction model for bloodstream infection(BSI)induced by carbapenem-resistant Klebsiella pneumoniae(CRKP).METHODS Retrospective analysis was conducted for clinical data from 253 patients with BSI induced by K.pneumoniae in the First Hospital of Qinhuangdao from January 2019 to June 2022.Patients admitted from January 2019 to December 2021 were selected as the model group(n=223),and patients admitted from January 2022 to June 2022 were selected as the validation group(n=30).The model group was divided into the CRKP subgroup(n=56)and the carbapenem-sensitive K.pneumoniae(CSKP)subgroup(n=167)based on whether CRKP was detected or not.The univariate and multivariate Logistic analyses were performed on basic information such as gender,age and comorbid underlying diseases in two subgroups of patients;independent risk factors were screened for CRKP-induced BSI,and a risk prediction model was constructed.The established model was verified with patients in the validation group as the target.RESULTS Admissioning to intensive care unit(ICU),use of immunosuppressants,empirical use of carbapenems and empirical use of antibiotics against Gram-positive coccus were independent risk factors of CRKP-induced BSI(ORs were 3.749,3.074,2.909,9.419,95%CIs were 1.639-8.572,1.292-7.312,1.180-7.717,2.877-30.840,P＜0.05).Based on this,a risk prediction model was established with a P value of 0.365.The AUC of the receiver operating characteristic(ROC)curve of the model was 0.848[95%CI(0.779,0.916),P＜0.001],and the critical score was 6.5.In the validation group,the overall accuracy of the prediction under the model was 86.67%,and the AUC of ROC curve was 0.926[95%CI(0.809,1.000],P＜0.001].CONCLUSIONS Admission to ICU,use of immunosuppressants,empirical use of carbapenems and empirical use of antibiotics against Gram-positive coccus are independent risk factors of CRKP-induced BSI.The CRKP-induced BSI risk prediction model based on the above factors has good prediction accuracy.关键词
碳青霉烯类耐药肺炎克雷伯菌/血流感染/危险因素/风险预测模型Key words
carbapenem-resistant Klebsiella pneumoniae/bloodstream infection/risk factors/risk prediction model分类
医药卫生引用本文复制引用
于小杰,杨文明,宋萍萍,魏颖,王娜..碳青霉烯类耐药肺炎克雷伯菌致血流感染风险预测模型的构建[J].中国药房,2024,35(1):75-79,5.基金项目
秦皇岛市科学技术研究与发展计划项目(No.202004A088,No.201902A210) （No.202004A088,No.201902A210）
