{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:14:53Z","timestamp":1761059693686},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,3,24]],"date-time":"2014-03-24T00:00:00Z","timestamp":1395619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2014,5]]},"abstract":"Abstract<\/jats:title>Background and objective<\/jats:title>Health care\u2010associated pneumonia (HCAP<\/jats:styled-content>) and drug\u2010resistant bacterial pneumonia may not share identical risk factors. We have shown that bronchiectasis, recent hospitalization and severe pneumonia (confusion, blood urea level, respiratory rate, low blood pressure and 65 year old (CURB<\/jats:styled-content>\u201065) score \u22653) were independent predictors of pneumonia caused by potentially drug\u2010resistant (PDR<\/jats:styled-content>) pathogens. This study aimed to develop and validate a clinical risk score for predicting drug\u2010resistant bacterial pneumonia in older patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>We derived a risk score by assigning a weighting to each of these risk factors as follows: 14, bronchiectasis; 5, recent hospitalization; 2, severe pneumonia. A 0.5 point was defined for the presence of other risk factors for HCAP<\/jats:styled-content>. We compared the areas under the receiver\u2010operating characteristics curve (AUROC<\/jats:styled-content>) of our risk score and the HCAP<\/jats:styled-content> definition in predicting PDR<\/jats:styled-content> pathogens in two cohorts of older patients hospitalized with non\u2010nosocomial pneumonia.<\/jats:p><\/jats:sec>Results<\/jats:title>The derivation and validation cohorts consisted of 354 and 96 patients with bacterial pneumonia, respectively. PDR<\/jats:styled-content> pathogens were isolated in 48 and 21 patients in the derivation and validation cohorts, respectively. The AUROC<\/jats:styled-content>s of our risk score and the HCAP<\/jats:styled-content> definition were 0.751 and 0.650, respectively, in the derivation cohort, and were 0.782 and 0.671, respectively, in the validation cohort. The differences between our risk score and the HCAP<\/jats:styled-content> definition reached statistical significance. A score \u22652.5 had the best balance between sensitivity and specificity.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Our risk score outperformed the HCAP<\/jats:styled-content> definition to predict pneumonia caused by PDR<\/jats:styled-content> pathogens. A history of bronchiectasis or recent hospitalization is the major indication of starting empirical broad\u2010spectrum antibiotics.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.12267","type":"journal-article","created":{"date-parts":[[2014,3,24]],"date-time":"2014-03-24T11:09:00Z","timestamp":1395659340000},"page":"549-555","source":"Crossref","is-referenced-by-count":15,"title":["Development and validation of a clinical risk score for predicting drug\u2010resistant bacterial pneumonia in older C<\/scp>hinese patients"],"prefix":"10.1111","volume":"19","author":[{"given":"Hon Ming","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Medicine and Therapeutics Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Microbiology Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David SC","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,3,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.20.2205"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir813"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir840"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.109785"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hct152"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12036"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-200630"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.124776"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2012.10.002"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2010.08.015"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12110"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2012.04.003"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e32835023fb"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2012.07.006"}],"container-title":["Respirology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fresp.12267","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/resp.12267","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T20:44:33Z","timestamp":1696020273000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/resp.12267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,3,24]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014,5]]}},"alternative-id":["10.1111\/resp.12267"],"URL":"https:\/\/doi.org\/10.1111\/resp.12267","archive":["Portico"],"relation":{},"ISSN":["1323-7799","1440-1843"],"issn-type":[{"value":"1323-7799","type":"print"},{"value":"1440-1843","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,3,24]]}}}