Moghnieh et al reported a score for predicting carbapenem resistance in a Enterobacterales colonizing or infecting an inpatient. The authors are from multiple institutions in Lebanon.
Patient selection: hospital inpatient colonized or infected with an Enterobacterales showing third generation cephalosporin resistance
Parameters:
(1) history of cerebrovascular disease
(2) history of hematopoietic cell transplant (HSCT)
(3) chronic wound
(4) history of endoscopy during the 3 months prior to the index hospitalization
(5) nosocomial acquisition of the Enterobacterales
(6) prior therapy with meropenem in the 3 months prior to acquisition
|
Parameter
|
Finding
|
Points
|
|
history of cerebrovascular disease
|
no
|
0
|
|
|
yes
|
2
|
|
history of HSCT
|
no
|
0
|
|
|
yes
|
8
|
|
chronic wound
|
no
|
0
|
|
|
yes
|
3
|
|
history of endoscopy
|
no
|
0
|
|
|
yes
|
3
|
|
nosocomial acquisition
|
definite
|
0
|
|
|
in question
|
3
|
|
prior use of merepenem
|
no
|
0
|
|
|
yes
|
6
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 25
• A score >= 5 indicates a high risk of carbapenem resistance.
Performance:
• At the cutoff >=5, the score had a sensitivity of 0.65 and specificity of 0.86.
• The area under the ROC curves is 0.79.
