Development a risk prediction nomogram for multidrug−resistant bacterial and fungal infection in gastrointestinal fistula patients during the perioperative period
BackgroundThis study aims to develop a risk prediction model for multidrug-resistant bacterial and fungal infections in patients with gastrointestinal fistulas during the perioperative period.MethodsA retrospective cohort study was conducted at Anhui No. 2 Provincial People’s Hospital from January 2...
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Frontiers Media S.A.
2024-11-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2024.1502529/full |
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| author | Mingming Yin Haoyi Zheng Haoyi Zheng Lifeng Xu Rong Jin Xiangyang Wang Yi Man Kai Xu Qiang Ruan Ting Wang Kai Guo Zheng Zhou Wenyong Wu Guosheng Gu Guosheng Gu |
| author_facet | Mingming Yin Haoyi Zheng Haoyi Zheng Lifeng Xu Rong Jin Xiangyang Wang Yi Man Kai Xu Qiang Ruan Ting Wang Kai Guo Zheng Zhou Wenyong Wu Guosheng Gu Guosheng Gu |
| author_sort | Mingming Yin |
| collection | DOAJ |
| description | BackgroundThis study aims to develop a risk prediction model for multidrug-resistant bacterial and fungal infections in patients with gastrointestinal fistulas during the perioperative period.MethodsA retrospective cohort study was conducted at Anhui No. 2 Provincial People’s Hospital from January 2022 to July 2024. We analyzed the distribution, resistance patterns, and mechanisms of multidrug resistance. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. A nomogram was constructed based on these risk factors, and its performance was evaluated using calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA).ResultsA total of 266 patients were included, with 157 (59.02%) testing positive for multidrug-resistant infections. We isolated 329 pathogenic strains: 84 Gram-positive (25.53%), 215 Gram-negative (65.35%), and 30 fungal strains (9.11%). The most common isolate was Klebsiella pneumoniae (57 strains, 17.33%). Patients were divided into a training cohort (n = 177) and a validation cohort (n = 89). Multivariate analysis identified six key indicators: secondary surgery, length of hospital stay, preoperative white blood cell (WBC) count, preoperative neutrophil count, postoperative WBC count, and postoperative C-reactive protein (CRP) levels. The nomogram demonstrated excellent predictive ability, with an area under the curve (AUC) of 0.905 in the training cohort and 0.793 in the validation cohort. Calibration curves indicated high consistency between predicted probabilities and observed values. DCA confirmed the clinical utility of the nomogram.ConclusionOur study shows that multidrug-resistant infections in patients with gastrointestinal fistulas are predominantly caused by Gram-negative bacilli, especially carbapenem-resistant Enterobacteriaceae. Key risk factors include secondary surgery and various blood count parameters. The developed nomogram provides robust predictive accuracy, aiding healthcare providers in implementing targeted infection prevention strategies. |
| format | Article |
| id | doaj-art-68e9de5c208041d88003b208c8e3f0b4 |
| institution | Kabale University |
| issn | 2235-2988 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj-art-68e9de5c208041d88003b208c8e3f0b42024-11-28T06:33:15ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882024-11-011410.3389/fcimb.2024.15025291502529Development a risk prediction nomogram for multidrug−resistant bacterial and fungal infection in gastrointestinal fistula patients during the perioperative periodMingming Yin0Haoyi Zheng1Haoyi Zheng2Lifeng Xu3Rong Jin4Xiangyang Wang5Yi Man6Kai Xu7Qiang Ruan8Ting Wang9Kai Guo10Zheng Zhou11Wenyong Wu12Guosheng Gu13Guosheng Gu14Department of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, The Graduate School of Bengbu Medical University, Bengbu, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, Anhui No.2 Provincial People’s Hospital, Hefei, ChinaDepartment of General Surgery, The Graduate School of Bengbu Medical University, Bengbu, ChinaBackgroundThis study aims to develop a risk prediction model for multidrug-resistant bacterial and fungal infections in patients with gastrointestinal fistulas during the perioperative period.MethodsA retrospective cohort study was conducted at Anhui No. 2 Provincial People’s Hospital from January 2022 to July 2024. We analyzed the distribution, resistance patterns, and mechanisms of multidrug resistance. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. A nomogram was constructed based on these risk factors, and its performance was evaluated using calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA).ResultsA total of 266 patients were included, with 157 (59.02%) testing positive for multidrug-resistant infections. We isolated 329 pathogenic strains: 84 Gram-positive (25.53%), 215 Gram-negative (65.35%), and 30 fungal strains (9.11%). The most common isolate was Klebsiella pneumoniae (57 strains, 17.33%). Patients were divided into a training cohort (n = 177) and a validation cohort (n = 89). Multivariate analysis identified six key indicators: secondary surgery, length of hospital stay, preoperative white blood cell (WBC) count, preoperative neutrophil count, postoperative WBC count, and postoperative C-reactive protein (CRP) levels. The nomogram demonstrated excellent predictive ability, with an area under the curve (AUC) of 0.905 in the training cohort and 0.793 in the validation cohort. Calibration curves indicated high consistency between predicted probabilities and observed values. DCA confirmed the clinical utility of the nomogram.ConclusionOur study shows that multidrug-resistant infections in patients with gastrointestinal fistulas are predominantly caused by Gram-negative bacilli, especially carbapenem-resistant Enterobacteriaceae. Key risk factors include secondary surgery and various blood count parameters. The developed nomogram provides robust predictive accuracy, aiding healthcare providers in implementing targeted infection prevention strategies.https://www.frontiersin.org/articles/10.3389/fcimb.2024.1502529/fullmultidrug-resistant infectionsgastrointestinal fistulasgram-negative bacillinomogramperioperative period |
| spellingShingle | Mingming Yin Haoyi Zheng Haoyi Zheng Lifeng Xu Rong Jin Xiangyang Wang Yi Man Kai Xu Qiang Ruan Ting Wang Kai Guo Zheng Zhou Wenyong Wu Guosheng Gu Guosheng Gu Development a risk prediction nomogram for multidrug−resistant bacterial and fungal infection in gastrointestinal fistula patients during the perioperative period Frontiers in Cellular and Infection Microbiology multidrug-resistant infections gastrointestinal fistulas gram-negative bacilli nomogram perioperative period |
| title | Development a risk prediction nomogram for multidrug−resistant bacterial and fungal infection in gastrointestinal fistula patients during the perioperative period |
| title_full | Development a risk prediction nomogram for multidrug−resistant bacterial and fungal infection in gastrointestinal fistula patients during the perioperative period |
| title_fullStr | Development a risk prediction nomogram for multidrug−resistant bacterial and fungal infection in gastrointestinal fistula patients during the perioperative period |
| title_full_unstemmed | Development a risk prediction nomogram for multidrug−resistant bacterial and fungal infection in gastrointestinal fistula patients during the perioperative period |
| title_short | Development a risk prediction nomogram for multidrug−resistant bacterial and fungal infection in gastrointestinal fistula patients during the perioperative period |
| title_sort | development a risk prediction nomogram for multidrug resistant bacterial and fungal infection in gastrointestinal fistula patients during the perioperative period |
| topic | multidrug-resistant infections gastrointestinal fistulas gram-negative bacilli nomogram perioperative period |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2024.1502529/full |
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