Variablesa | Total n = 879 | Training cohort n = 761 | Validation cohort n = 118 | P-value |
---|---|---|---|---|
Demographics | ||||
Age (years) | 65 (52–74) | 64 (52–73) | 66 (55–79) | 0.026 |
Gender | ||||
 Male  Female | 585 (66.6) 294 (33.4) | 513 (67.4) 248 (32.6) | 72 (61.0) 46 (39.0) | 0.171 - |
Weight (kg) | 60 (53–67) | 60 (54–67) | 56 (50.4–62.3) | < 0.001 |
CRE Colonization status | ||||
Primary colonization organism | ||||
 Klebsiella pneumoniae  Escherichia coli | 803 (91.4) 76 (8.6) | 697 (91.6) 64 (8.4) | 106 (89.8) 12 (10.2) | 0.527 - |
First specimen of colonization | ||||
Rectal swab  Sputum  Urine | 573 (65.2) 183 (20.8) 123 (14.0) | 496 (65.2) 164 (21.6) 101 (13.3) | 77 (65.3) 19 (16.1) 22 (18.6) | 0.987 0.175 0.118 |
Multisite colonization | 294 (33.4) | 257 (33.8) | 37 (31.4) | 0.605 |
Polymicrobial colonization | 149 (17.0) | 130 (17.1) | 19 (16.1) | 0.792 |
Concurrent fungal colonization | 234 (26.6) | 209 (27.5) | 25 (21.2) | 0.151 |
Time to detect CRE colonization after admission (days) | 14 (14–22) | 14 (14–23) | 14 (14–21) | 0.333 |
Hepatic function | ||||
ALT (U/L) | 44 (22–86) | 46 (23–88) | 35 (16.8–70.3) | 0.006 |
AST (U/L) | 39 (22–79) | 39 (22–81) | 33.5 (18.8–59.8) | 0.021 |
TBil (µmol/L) | 13.9 (9.5–23.1) | 14.5 (10–23.6) | 10 (6.4–21.5) | < 0.001 |
Renal function | ||||
BUN (mmol/L) | 5.3 (4–6.9) | 5.2 (4–6.7) | 6.1 (4.4–9.5) | < 0.001 |
CrCl (mL/min/1.73 m2) | 69.5 (41.5–104.3) | 69.0 (42.1–102.7) | 71.4 (40.4–107.0) | 0.952 |
Invasive procedure and/or devices | ||||
CRRT | 387 (44.0) | 338 (44.4) | 49 (41.5) | 0.556 |
ECMO | 14 (1.6) | 13 (1.7) | 1 (0.8) | 0.764 |
Mechanical ventilation | 309 (35.2) | 270 (35.5) | 39 (33.1) | 0.607 |
Vasoactive drugs | 256 (29.1) | 207 (27.2) | 43 (36.4) | 0.038 |
Catheterization | 267 (30.4) | 234 (30.7) | 33 (28.0) | 0.541 |
Comorbidities | ||||
Hypertension | 330 (37.5) | 294 (38.6) | 36 (30.5) | 0.090 |
Cardiovascular diseases | 333 (37.9) | 282 (37.1) | 51 (43.2) | 0.199 |
Cerebrovascular diseases | 210 (23.9) | 181 (23.8) | 29 (24.6) | 0.851 |
Respiratory diseases | 499 (56.8) | 443 (58.2) | 56 (47.5) | 0.028 |
Gastrointestinal diseases | 259 (29.5) | 225 (29.6) | 34 (28.8) | 0.867 |
Liver diseases | 304 (34.6) | 258 (33.9) | 46 (39.0) | 0.280 |
Renal diseases | 291 (33.1) | 257 (33.8) | 34 (28.8) | 0.287 |
Diabetes mellitus | 215 (24.5) | 183 (24.0) | 32 (27.1) | 0.470 |
Malignancy | 187 (21.3) | 157 (20.6) | 30 (25.4) | 0.237 |
Autoimmune diseases | 8 (0.9) | 8 (1.1) | 0 | < 0.001 |
Solid organ transplantation | 22 (2.5) | 22 (2.9) | 0 | < 0.001 |
CCI score | 4 (3–5) | 5 (3–5) | 4 (3–5) | < 0.001 |
Prior healthcare history within 90 days of CRE-colonized detection | ||||
Hospitalization | 393 (44.7) | 341 (44.8) | 52 (44.1) | 0.880 |
ICU admission | 276 (31.4) | 236 (31.0) | 40 (33.9) | 0.530 |
Surgery | 249 (28.3) | 216 (28.4) | 33 (28.0) | 0.925 |
Antimicrobial treatment | 370 (42.1) | 323 (42.4) | 61 (51.7) | 0.059 |
Antimicrobial agents | ||||
CAZ/AVI Polymyxins Carbapenems Tigecycline Aminoglycosides Fosfomycin Fluoroquinolones | 33 (3.8) 80 (9.1) 141 (16.0) 124 (14.1) 46 (5.2) 51 (5.8) 125 (14.2) | 27 (3.5) 69 (9.1) 116 (15.2) 107 (14.1) 38 (5.0) 44 (5.8) 105 (13.8) | 6 (5.1) 11 (9.3) 25 (21.2) 17 (14.4) 8 (6.8) 7 (5.9) 20 (16.9) | 0.414 0.929 0.102 0.920 0.418 0.948 0.362 |
Antimicrobial combination therapy | 140 (15.9) | 115 (15.1) | 25 (21.2) | 0.093 |
Antimicrobial treatment duration (days) | 25 (19–32) | 26 (21–31) | 19 (10–38) | 0.052 |
Concomitant drugs | ||||
GCs | 382 (43.5) | 333 (43.8) | 49 (41.5) | 0.649 |
PPIs | 455 (51.8) | 402 (52.8) | 53 (44.9) | 0.110 |
Albumin | 386 (43.9) | 342 (45.0) | 44 (37.3) | 0.119 |
Immunosuppressants | 29 (3.3) | 28 (3.7) | 1 (0.8) | 0.185 |
Opioids | 98 (11.1) | 91 (12.0) | 7 (5.9) | 0.053 |
Clinical outcomes | ||||
CRE infection after colonization within 30 days | 160 (18.2) | 141 (18.5) | 19 (16.1) | 0.525 |
CRE infection after colonization within 60 days | 221 (25.1) | 196 (25.8) | 25 (21.2) | 0.287 |
Time to diagnosis of CRE infection after colonization (days) | 20 (14–32) | 21 (14.3–32) | 19 (13.5–30.5) | 0.443 |
All-cause 60-day mortality | 196 (22.3) | 170 (22.3) | 26 (22.0) | 0.941 |