Abstract：
We developed a prediction model for cefotaxime resistance in patients with K. pneumoniae bacteremia. Adult patients with K. pneumoniae bacteremia were grouped into derivation (from March 2018 to December 2019) and validation (from January 2020 to August 2020) cohorts. The prediction scoring system was based on factors associated with cefotaxime resistance identified by the logistic regression model. A total of 358 patients were enrolled (256 for derivation, 102 for validation). In the multivariable analysis, age ≥65 years, hospital-acquired infection, prior antimicrobial use, and an updated Charlson comorbidity index ≥3 points were associated with cefotaxime resistance in the derivation cohort. When each variable was counted as 1 point, the values of the area under the curve were 0.761 in the derivation and 0.781 in the validation cohorts. The best cutoff value using the Youden index was ≥2 with 73.6% sensitivity and 67.5% specificity. Our simple scoring system favorably predicted cefotaxime resistance.
摘要：
我们建立了肺炎克雷伯菌菌血症患者对头孢噻肟耐药的预测模型。将肺炎克雷伯菌菌血症的成年患者分为衍生（2018年3月至2019年12月）和验证（2020年1月至2020年8月）队列。预测评分系统基于逻辑回归模型确定的与头孢噻肟耐药相关的因素。共纳入358例患者(256例用于推导，102用于验证)。在多变量分析中，年龄≥65岁，医院获得性感染，先前使用抗菌药物，在衍生队列中,更新的Charlson合并症指数≥3分与头孢噻肟耐药相关.当每个变量计为1点时，曲线下面积的值在推导中为0.761,在验证队列中为0.781.使用Youden指数的最佳临界值为≥2，敏感性为73.6％，特异性为67.5％。我们简单的评分系统可以很好地预测头孢噻肟的耐药性。
