耐碳青霉烯类肺炎克雷伯菌感染风险预测模型的构建及验证

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中图分类号R978.1 文献标志码A 文章编号 1001-0408（2025）14-1786-06

DOI 10.6039/j.issn.1001-0408.2025.14.17

ABSTRACTOBJECTIVETo investigatetheindependentriskfactorsforcarbapenem-restantKlebsiellpneumoniae（CRKP） infection，developanomogrampredictionmodelandvalidateit.METHODsClinicaldataofhospitalizedpatientsinfectedwith CRKPbetweenApril220andMay2023atKunmingFirstPeople'sHospitalwereretrospectivelycolectedandmatched1：1with patients infectedwithcarbapenem-susceptible Klebsiell pneumoniae（CSKP）during thesameperiodasthemodelinggroup.Using thesamecriteria，datafrompatientshospitalizedandinfectedwithCRKPandmatchedCSKPbetweenJune2023andJune2024 werecolectedasthevalidationgroup.Univariateanalysis，LASSOregressionandmultivariateLogisticregressionwerecoducted toidentifyindependentriskfactorsforCRKPinfectionandtodevelopanomogrampredictionmodel.Intermalvalidationof the modelwas performedusing Botstrapresampling，andexternalvalidation wascarredoutusingthedataofvalidationgroup.The

predictive performance of the model was evaluated using receiver operating characteristic （ROC）curvesand calibration plots.RESULTS A total of53O patientswere enrolled，with 372in the modeling group and 158 in the validation group. Cerebrovascular disease，indwelling gastric tube，mechanical ventilation，exposure to carbapenem antibiotics，and exposure to β -lactamase inhibitor compound agents were identified as independent risk factors for CRKP infection（ 1<0.05 .The nomogram predicting CRKP infection risk achieved an area underROCofO.729andO.803ininternalandexteralvalidations，respectively.Calibrationcurvesindicatedahighdegreof consistency betweenpredictedandobserved probabilies.CONCLUSIONs Cerebrovasculardisease，indweling gastrictube， mechanical ventilation，exposure to carbapenem antibiotics，and exposure to β -lactamase inhibitor compound agent are independent riskfactorsforCRKPinfection.Thedeveloped nomogrammodelforpredictingCRKPinfectionrisk demonstratesgoodpredictive performance and can aid in the early identification of patients at high risk for CRKP infection. KEYWORDScarbapenem-resistant Klebsiel pneumoniae；risk factors；nomogram；predictive model

碳青霉烯类抗生素是治疗肺炎克雷伯菌感染的有效抗菌药物。（剩余10670字）