{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:27:57Z","timestamp":1790296077313,"version":"4.1.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Center for Advancing Translational Sciences of the National Institutes of Health","award":["UL1TR002538"],"award-info":[{"award-number":["UL1TR002538"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32HG008962"],"award-info":[{"award-number":["T32HG008962"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services","award":["R01HD102540"],"award-info":[{"award-number":["R01HD102540"]}]},{"name":"National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services","award":["R01AI135114"],"award-info":[{"award-number":["R01AI135114"]}]},{"name":"National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services","award":["U19AI110818"],"award-info":[{"award-number":["U19AI110818"]}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01CK000633"],"award-info":[{"award-number":["U01CK000633"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01CK000490"],"award-info":[{"award-number":["U01CK000490"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Extended spectrum beta-lactamase producing Enterobacterales (ESBL-PE) present a risk to public health by limiting the efficacy of multiple classes of beta-lactam antibiotics against infection. International travellers may acquire these organisms and identifying individuals at high risk of acquisition could help inform clinical treatment or prevention strategies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used data collected from a cohort of 528 international travellers enrolled in a multicentre US-based study to derive a clinical prediction rule (CPR) to identify travellers who developed ESBL-PE colonization, defined as those with new ESBL positivity in stool upon return to the United States. To select candidate features, we used data collected from pre-travel and post-travel questionnaires, alongside destination-specific data from external sources. We utilized LASSO regression for feature selection, followed by random forest or logistic regression modelling, to derive a CPR for ESBL acquisition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A CPR using machine learning and logistic regression on 10 features has an internally cross-validated area under the receiver operating characteristic curve (cvAUC) of 0.70 (95% confidence interval 0.69\u20130.71). We also demonstrate that a four-feature model performs similarly to the 10-feature model, with a cvAUC of 0.68 (95% confidence interval 0.67\u20130.69). This model uses traveller\u2019s diarrhoea, and antibiotics as treatment, destination country waste management rankings and destination regional probabilities as predictors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We demonstrate that by integrating traveller characteristics with destination-specific data, we could derive a CPR to identify those at highest risk of acquiring ESBL-PE during international travel.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/taad028","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T04:50:12Z","timestamp":1677819012000},"source":"Crossref","is-referenced-by-count":15,"title":["Development of a prediction model for the acquisition of extended spectrum beta-lactam-resistant organisms in U.S. international travellers"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8779-7048","authenticated-orcid":false,"given":"David Garrett","family":"Brown","sequence":"first","affiliation":[{"name":"University of Utah School of Medicine Division of Infectious Diseases, , Salt Lake City, UT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin J","family":"Worby","sequence":"additional","affiliation":[{"name":"Broad Institute of MIT and Harvard Infectious Disease and Microbiome Program, , Cambridge, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa A","family":"Pender","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine Division of Infectious Diseases, , Salt Lake City, UT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben J","family":"Brintz","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine Division of Epidemiology, , Salt Lake City, UT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward T","family":"Ryan","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA , USA"},{"name":"Massachusetts General Hospital Travelers\u2019 Advice and Immunization Center, , Boston, MA , USA"},{"name":"Massachusetts General Hospital Division of Infectious Diseases, , Boston, MA , USA"},{"name":"Massachusetts General Hospital Department of Medicine, , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushmita","family":"Sridhar","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA , USA"},{"name":"Massachusetts General Hospital Division of Infectious Diseases, , Boston, MA , USA"},{"name":"Massachusetts General Hospital Department of Medicine, , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Oliver","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Division of Infectious Diseases, , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason B","family":"Harris","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Division of Infectious Diseases, , Boston, MA , USA"},{"name":"Harvard Medical School, Boston Department of Pediatrics, , MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3603-8110","authenticated-orcid":false,"given":"Sarah E","family":"Turbett","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA , USA"},{"name":"Massachusetts General Hospital Division of Infectious Diseases, , Boston, MA , USA"},{"name":"Massachusetts General Hospital Department of Pathology, , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sowmya R","family":"Rao","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health Department of Global Health, , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlee M","family":"Earl","sequence":"additional","affiliation":[{"name":"Broad Institute of MIT and Harvard Infectious Disease and Microbiome Program, , Cambridge, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina C","family":"LaRocque","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA , USA"},{"name":"Massachusetts General Hospital Travelers\u2019 Advice and Immunization Center, , Boston, MA , USA"},{"name":"Massachusetts General Hospital Division of Infectious Diseases, , Boston, MA , USA"},{"name":"Massachusetts General Hospital Department of Medicine, , Boston, MA , 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