To explore the related risk factors of CRKP infection in ICU patients and the construction of prediction model
Objective To explore the risk factors of carbapenem-resistant Klebsiella pneumoniae(CRKP)infection in intensive care unit(ICU)patients and construct a predictive model.Methods A total of 144 patients with Klebsiella pneumoniae(KP)infection identified by bacterial culture in ICU units of Northern Jiangsu People's Hospital from December 2019 to August 2021 were retrospectively selected to construct a model group.According to whether they were resistant to carbapenem antibiotics,they were divided into CRKP group and carbapenem-susceptible Klebsiella pneumoniae(CSKP)group.Multivariate logistic regression was used to analyze the influencing factors of CRKP infection in patients and to construct a risk prediction model for CRKP infection.The accuracy of the model was judged by ROC curve.In addition,101 patients with KP infection in ICU who met the inclusion criteria in Subei People's Hospital of Jiangsu Province from September 2021 to December 2022 were selected to predict the success rate,and the results were compared with the actual observed results,and the fitting degree of the model was evaluated by Hosmer-Lemeshow test.Results There were 50 cases(34.72%)in CSKP group and 94 cases(65.28%)in CRKP group.CRP(OR=1.116,95%CI=1.041-1.196,P=0.002),BNP(OR=1.067,95%CI=1.016～1.122,P=0.010),use of≥2 antibiotics(OR=20.279,95%CI=1.784～230.560,P=0.015)and surgery(OR=31.735,95%CI=1.961～513.496,P=0.015)were independent influencing factors for CRKP infection in both groups(P<0.05).On this basis,a risk prediction model is established.The area under the ROC curve was 0.907,95%CI=0.982～1.000,the sensitivity was 91.50%,the specificity was 100.00%,and the Youden index was 0.915.The total prediction accuracy of the external validation model was 99.20%,and the Hosmer-Lemeshow test showed χ2=2.072,P=0.979.Conclusion The predictive model of CRKP infection has excellent predictive efficacy.CRP,BNP,use of≥2 antibiotics and surgery are the main influencing factors of CRKP infection in ICU patients.Nurses should focus on patients with abnormal indicators when intervening.
Intensive care unitCarbapenem-resistant Klebsiella pneumoniaeRisk factorsPrediction model
万方数据
维普
