{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:35:19Z","timestamp":1790393719710,"version":"4.1.0"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":641,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:sec id=\"S0195941700032720_abs1\"><jats:title>Objective.<\/jats:title><jats:p>To validate the utility of a previously published scoring model (Italian) to identify patients infected with community-onset extended-spectrum \u03b2-lactamase-producing Enterobacteriaceae (ESBL-EKP) and develop a new model (Duke) based on local epidemiology.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700032720_abs2\"><jats:title>Methods.<\/jats:title><jats:p>This case-control study included patients 18 years of age or more admitted to Duke University Hospital between January 1, 2008, and December 31, 2010, with culture-confirmed infection due to an ESBL-EKP (cases). Uninfected controls were matched to cases (3 : 1). The Italian model was applied to our patient population for validation. The Duke model was developed through logistic-regression-based prediction scores calculated on variables independently associated with ESBL-EKP isolation. Sensitivities and specificities at various point cutoffs were determined, and determination of the area under the receiver operating characteristic curve (ROC AUC) was performed.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700032720_abs3\"><jats:title>Results.<\/jats:title><jats:p>A total of 123 cases and 375 controls were identified. Adjusted odds ratios and 95% confidence intervals for variables previously identified in the Italian model were as follows: hospitalization (3.20 [1.62\u20136.55]), transfer (4.31 [2.15\u20138.78]), urinary catheterization (5.92 [3.09\u201311.60]), \u03b2-lactam and\/or fluoroquinolone therapy (3.76 [2.06\u20136.95]), age 70 years or more (1.55 [0.79\u20133.01]), and Charlson Comorbidity Score of 4 or above (1.06 [0.55\u20132.01]). Sensitivity and specificity were, respectively, more than or equal to 95% and less than or equal to 47% for scores 3 or below and were less than or equal to 50% and more than or equal to 96% for scores 8 or above. The ROC AUC was 0.88. Variables identified in the Duke model were as follows: hospitalization (2.63 [1.32\u20135.41]), transfer (5.30 [2.67\u201310.71]), urinary catheterization (6.89 [3.62\u201313.38]), \u03b2-lactam and\/or fluoroquinolone therapy (3.47 [1.91\u20136.41]), and immunosuppression (2.34 [1.14\u20134.80]). Sensitivity and specificity were, respectively, more than or equal to 94% and less than or equal to 65% for scores 3 or below and were less than or equal to 58% and more than or equal to 95% for scores 8 or above. The ROC AUC was 0.89.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700032720_abs4\"><jats:title>Conclusion.<\/jats:title><jats:p>While the previously reported model was an excellent predictor of community-onset ESBL-EKP infection, models utilizing factors based on local epidemiology may be associated with improved performance.<\/jats:p><\/jats:sec>","DOI":"10.1086\/669858","type":"journal-article","created":{"date-parts":[[2013,2,14]],"date-time":"2013-02-14T17:30:13Z","timestamp":1360863013000},"page":"385-392","source":"Crossref","is-referenced-by-count":65,"title":["Utility of a Clinical Risk Factor Scoring Model in Predicting Infection with Extended-Spectrum \u03b2-Lactamase-Producing Enterobacteriaceae on Hospital Admission"],"prefix":"10.1017","volume":"34","author":[{"given":"Steven W.","family":"Johnson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deverick J.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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