{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T04:17:35Z","timestamp":1745554655944,"version":"3.40.4"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"unspecified","delay-in-days":113,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X25000701_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>To identify institution-specific risk factors for extended-spectrum beta-lactamase (ESBL) bloodstream infections (BSI) to develop and validate a risk assessment scoring tool that can be utilized for hospitalized patients.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000701_as2\">\n\t    <jats:title>Design:<\/jats:title>\n\t    <jats:p>Single-center, retrospective, case-control study.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000701_as3\">\n\t    <jats:title>Setting:<\/jats:title>\n\t    <jats:p>Tertiary teaching hospital.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000701_as4\">\n\t    <jats:title>Patients:<\/jats:title>\n\t    <jats:p>Hospitalized adult and pediatric patients with <jats:italic>E. coli<\/jats:italic> or <jats:italic>Klebsiella<\/jats:italic> spp. BSI were stratified based on ESBL production between August 2019 to July 2021. Exclusion criteria included patients &lt; 28 days old, a positive blood culture resulting prior to admission\/after discharge or a polymicrobial and\/or carbapenem-resistant BSI.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000701_as5\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>Multivariable logistic regression assessed predictors of ESBL in a derivation cohort. Predictors were applied to a novel validation BSI cohort using area under the receiver-operator characteristics curve (ROC AUC) to assess the reliability of identifying patients likely to harbor ESBL at the time of organism identification.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000701_as6\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>A total of 238 patients in the derivation cohort met inclusion criteria stratified as ESBL (n = 68) or non-ESBL (n = 170). Multivariable logistic regression demonstrated diabetes, 30-day history of invasive procedure or antibiotic use, and\/or history of ESBL as independent predictors of ESBL. After creation of an ESBL risk assessment tool, the results were applied to a validation cohort of 170 patients. This model displayed good calibration and discrimination with a strong predictive power (Hosmer-Lemeshow \u03c7<jats:sup>2<\/jats:sup>= 4.66, p = 0.19; ROC AUC = 0.88, 95% CI = 0.7909 \u2013 0.974).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000701_as7\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>A validated ESBL risk assessment tool reliably identified hospitalized patients likely to harbor ESBL <jats:italic>E. coli<\/jats:italic> or <jats:italic>Klebsiella<\/jats:italic> spp. BSI upon organism identification.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2025.70","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T08:08:19Z","timestamp":1745482099000},"source":"Crossref","is-referenced-by-count":0,"title":["Identification and validation of a risk assessment scoring tool for extended-spectrum beta-lactamase-producing Enterobacterales bacteremia at a tertiary teaching hospital"],"prefix":"10.1017","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1117-0470","authenticated-orcid":false,"given":"Victoria","family":"Gavaghan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica L.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen","family":"Shields","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9390-0475","authenticated-orcid":false,"given":"Jennifer","family":"Dela-Pena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"S2732494X25000701_ref3","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01169-07"},{"key":"S2732494X25000701_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"S2732494X25000701_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"S2732494X25000701_ref4","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00143-10"},{"key":"S2732494X25000701_ref27","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1742"},{"key":"S2732494X25000701_ref10","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-019-0599-y"},{"key":"S2732494X25000701_ref2","unstructured":"2. 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CLSI. Performance Standards for Antimicrobial Susceptibility Testing \u2013 Thirty First Edition: M100. 2021."},{"key":"S2732494X25000701_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S1684-1182(10)60038-2"},{"key":"S2732494X25000701_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2020.104315"},{"key":"S2732494X25000701_ref21","doi-asserted-by":"publisher","DOI":"10.1002\/phar.4646"},{"key":"S2732494X25000701_ref29","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.3.1089-1094.2004"},{"key":"S2732494X25000701_ref24","unstructured":"24. Kroger, A , Bahta, L , Long, S et al. General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP). https:\/\/www.cdc.gov\/vaccines\/hcp\/acip-recs\/general-recs\/index.html. 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