Khunkitti et al reported a simple score for identifying a patient with community-acquired pneumonia due to an Enterobacterales that is resistant to a third-generation cephalosporin. The authors are from Khon Kaen University and affiliated hospitals in Thailand.
CREPE is an acronym for Cephalosporin Resistant Enterobacterales community acquired Pneumonia Evaluation.
Patient selection: community-acquired pneumonia due Gram-negative rods from the order Enterobacterales
Parameters:
(1) number of hours hospitalized in the past month
(2) colonization with multidrug resistant (MDR) Enterobacterales
(3) number of days receiving intravenous antibiotics in past month
(4) number of days receiving intravenous antibiotics between 1.01 to 12 months before
Parameter
Finding
Points
hours hospitalized in past month
<= 48 hours
0
> 48 hours
1
colonization with MDR Enterobacterales
none
0
anywhere on body
1
number of days of IV antibiotics in past month
< 5 days
0
>= 5 days
2
number of days of IV antibiotics from 1 to 12 months before
< 5 days
0
>= 5 days
1.5
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 5.5
• A cut-off of 1.25 had a sensitivity of 0.88 and specificity of 0.74.
Performance:
• The area under the ROC curve is 0.88.
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