Background
Methods
Study characteristics
Variable definition
Bacterial detection
Statistical methods
Results
Variables | Culture-positive group; N = 952 | Culture-negative group; N = 1422 | P | OR(95%CI) |
---|---|---|---|---|
Age, yr, (IQR) | 59 [41–76] | 59 [42–75] | 0.44 | |
Heart rate, (IQR) | 110 [96–132] | 98 [74–120] | < 0.001 | |
Systolic pressure, mmHg, (IQR) | 111 [93–130] | 115 [96–135] | < 0.001 | |
Diastolic pressure, mmHg, (IQR) | 60 [50–76] | 60 [46–74] | 0.09 | |
Mean arterial pressure, mmHg, (IQR) | 77 [60–94] | 79 [62–92] | 0.002 | |
Respiratory rate, times, (IQR) | 23 [15-26] | 22 [18-28] | < 0.001 | |
Gender (male) | 632 (66.4%) | 939 (66.0%) | 0.859 | 1.01 (0.91–1.12) |
Fever | 438 (46.0%) | 439 (30.9%) | < 0.001 | 1.90 (1.61–2.26) |
Primary disease (%) | ||||
Infections | 189 (19.9%) | 105 (7.4%) | < 0.001 | 3.10 (2.41–4.01) |
Trauma | 204 (21.4%) | 351 (24.7%) | 0.066 | 1.12 (0.99–1.26) |
Cardio-cerebrovascular accident | 129 (13.6%) | 208 (14.6%) | 0.46 | 1.05 (0.91–1.22) |
Heart disease | 42 (4.4%) | 62 (4.4%) | 0.952 | 0.99 (0.78–1.26) |
Postoperative diseases | 55 (5.8%) | 118 (8.3%) | 0.021 | 1.28 (1.02–1.60) |
Internal medicine diseases | 59 (6.2%) | 38 (2.7%) | < 0.001 | 2.41 (1.58–3.65) |
Malignant tumor | 115 (12.1%) | 145 (10.2%) | 0.15 | 1.21 (0.93–1.57) |
Clinical characteristics (%) | ||||
Leukocytosis | 663 (69.6%) | 834 (58.6%) | < 0.001 | 1.61 (1.35–1.92) |
Thrombopenia | 168 (17.6%) | 96 (6.8%) | < 0.001 | 2.96 (2.26–3.86) |
Metabolic acidosis | 73 (7.7%) | 30 (2.1%) | < 0.001 | 2.32 (1.56–3.54) |
Mechanical ventilation | 686 (72.1%) | 817 (57.5%) | < 0.001 | 1.91 (1.60–2.28) |
Acute kidney injury | 248 (26.1%) | 228 (16.0%) | < 0.001 | 1.85 (1.51–2.26) |
Septic shock | 280 (29.4%) | 335 (23.6%) | 0.001 | 1.35 (1.12–1.63) |
History of glucocorticoids | 400 (42.0%) | 284 (20.0%) | < 0.001 | 2.90 (2.42–3.48) |
Immunosuppression | 465 (48.8%) | 400 (28.1%) | < 0.001 | 2.44 (2.06–2.90) |
Emergency admission | 583 (61.2%) | 778 (54.7%) | 0.002 | 1.30 (1.11–1.55) |
Invasive catheterization | 616 (64.7%) | 731 (51.4%) | < 0.001 | 1.73 (1.46–2.05) |
Operation history | 516 (54.2%) | 675 (47.5%) | < 0.001 | 0.338 (0.28–0.40) |
History of quinolones | 81 (8.5%) | 43 (3.0%) | < 0.001 | 2.98 (2.04–4.36) |
History of carbapenems | 479 (50.3%) | 221 (15.5%) | < 0.001 | 5.50 (4.54–6.67) |
History of cephalosporins | 454 (47.7%) | 456 (32.1%) | < 0.001 | 1.93 (1.63–2.29) |
Antibiotic regimens (%) | ||||
Carbapenems | 274 (28.8%) | 326 (22.9%) | 0.001 | 1.35 (1.13–1.64) |
Tigecycline | 200 (21.0%) | 69 (4.9%) | < 0.001 | 5.21 (3.91–6.95) |
Colistin or polymyxin | 87 (9.1%) | 23 (1.6%) | < 0.001 | 6.12 (3.83–9.76) |
Death (%) | 223 (23.4%) | 98 (6.9%) | < 0.001 | 1.95 (1.78–2.15) |
LOS of infection, days, (IQR) | 6.0 [1-26] | 5.0 [1-20] | < 0.001 | |
Length of ICU stay, days, (IQR) | 14.7 [3.0–41.3] | 9.0 [2.7–28.0] | < 0.001 |
Variables | P | OR (95%CI) |
---|---|---|
Heart rate | < 0.001 | 1.988 (1.783–2.394) |
Temperature | < 0.001 | 1.918 (1.733–2.214) |
Lymphocyte count | 0.049 | 1.25 (1.001–1.562) |
Procalcitonin | < 0.001 | 1.976 (1.269–2.684) |
Lactic acid | 0.013 | 1.226 (1.071–1.584) |
Total bilirubin | 0.007 | 1.596 (1.293–1.899) |
Albumin | < 0.001 | 1.057 (1.037–1.078) |
Metabolic acidosis | 0.036 | 1.434 (1.043–1.745) |
History of carbapenems | < 0.001 | 2.899 (2.271–3.702) |
History of glucocorticoids | < 0.001 | 2.253 (1.657–3.061) |
Model | AUROC | Accuracy | Sensitivity | Specificity | PPV | NPV | F1 |
---|---|---|---|---|---|---|---|
Bloodstream infection model | |||||||
Logistic regression | 0.81 | 74.3 | 65.2 | 80.1 | 67.4 | 78.5 | 0.66 |
Decision Tree | 0.77 | 76.0 | 64.1 | 83.6 | 71.1 | 78.7 | 0.67 |
Random Forest | 0.86 | 77.7 | 69.6 | 82.9 | 71.9 | 81.2 | 0.71 |
SVM | 0.83 | 76.5 | 66.3 | 82.8 | 70.9 | 79.6 | 0.69 |
XGBoost | 0.85 | 76.4 | 70.6 | 80.1 | 69.1 | 81.2 | 0.69 |
CRGNB bacteremia model | |||||||
Logistic regression | 0.86 | 74.0 | 87.0 | 62.0 | 67.8 | 83.8 | 0.76 |
Decision Tree | 0.69 | 70.8 | 86.9 | 56.0 | 64.5 | 82.3 | 0.74 |
Random Forest | 0.87 | 70.8 | 89.1 | 54.0 | 64.0 | 84.4 | 0.75 |
SVM | 0.88 | 75.0 | 87.0 | 64.0 | 69.0 | 84.2 | 0.77 |
XGBoost | 0.80 | 70.8 | 79.5 | 58.0 | 65.0 | 80.5 | 0.73 |
Variables | CRGNB N = 418 | Non-CRGNB N = 534 | P | OR(95%CI) |
---|---|---|---|---|
Age, yr, (IQR) | 60 [43–78] | 60 [43–77] | 0.76 | |
Heart rate, (IQR) | 112 [88–132] | 109 [87–130] | 0.075 | |
Systolic pressure, mmHg, (IQR) | 111 [87–135] | 111 [89–135] | 0.771 | |
Diastolic pressure, mmHg, (IQR) | 60 [45–77] | 60 [45–73] | 0.795 | |
Mean arterial pressure, mmHg, (IQR) | 77 [59–94] | 76 [60–94] | 0.769 | |
Respiratory rate, times, (IQR) | 24 [18-31] | 23 [18-28] | 0.028 | |
Gender (male) | 258 (61.7%) | 374 (70.1%) | 0.007 | 0.69 (0.53–0.90) |
Fever | 209 (50.0%) | 229 (42.9%) | 0.03 | 1.33 (1.03–1.72) |
Primary disease (%) | ||||
Infections | 91 (21.7%) | 98 (18.3%) | 0.18 | 1.23 (0.90–1.70) |
Trauma | 108 (25.8%) | 96 (17.9%) | 0.003 | 1.59 (1.16–2.17) |
Cardio-cerebrovascular accident | 59 (14.1%) | 70 (13.1%) | 0.653 | 1.09 (0.75–1.58) |
Heart disease | 21 (5.0%) | 21 (3.9%) | 0.416 | 1.29 (0.69–2.39) |
Postoperative diseases | 25 (6.0%) | 30 (5.6%) | 0.810 | 1.07 (0.62–1.85) |
Internal medicine diseases | 26 (6.2%) | 33 (6.1%) | 0.980 | 1.007 (0.59–1.72) |
Malignant tumor | 51 (12.2%) | 64 (11.9%) | 0.919 | 1.021 (0.68–1.51) |
Clinical characteristics (%) | ||||
Leukocytosis | 291 (69.6%) | 372 (69.7%) | 0.988 | 0.998 (0.75–1.31) |
Thrombopenia | 89 (21.2%) | 79 (14.8%) | 0.09 | 1.55 (1.11–2.18) |
Metabolic acidosis | 42 (10.0%) | 31 (5.8%) | 0.015 | 1.81 (1.12–2.94) |
Mechanical ventilation | 349 (83.5%) | 337 (63.1%) | < 0.001 | 2.95 (2.16–4.04) |
Acute kidney injury | 114 (27.2%) | 134 (25.1%) | 0.447 | 1.11 (0.84–1.49) |
Septic shock | 136 (32.5%) | 144 (26.9%) | 0.061 | 1.31 (0.98–1.73) |
History of glucocorticoids | 213 (50.9%) | 187 (35.0%) | < 0.001 | 1.92 (1.42–2.50) |
Immunosuppression | 245 (58.6%) | 220 (41.2%) | < 0.001 | 2.02 (1.55–2.62) |
Emergency admission | 244 (58.3%) | 339 (63.4%) | 0.108 | 0.81 (0.62–1.05) |
Invasive catheterization | 312 (74.6%) | 304 (56.9%) | < 0.001 | 2.23 (1.69–2.94) |
Operation history | 236 (56.4%) | 280 (52.4%) | 0.216 | 1.17 (0.91–1.52) |
History of quinolones | 51 (12.2%) | 30 (5.62%) | < 0.001 | 2.34(1.45–3.74) |
History of carbapenems | 279 (66.7%) | 200 (37.5%) | < 0.001 | 3.35 (2.56–4.38) |
History of cephalosporins | 232 (55.5%) | 222 (41.6%) | < 0.001 | 1.75 (1.35–2.27) |
Variables | P | OR (95%CI) |
---|---|---|
C-reactive protein | 0.025 | 1.28 (1.06–1.59) |
prothrombin time | 0.011 | 1.34 (1.11–1.48) |
Trauma | 0.002 | 1.78 (1.22–2.61) |
Mechanical ventilation | < 0.001 | 1.94 (1.35–2.81) |
Invasive catheterization | < 0.001 | 1.66 (1.22–2.27) |
History of carbapenems | < 0.001 | 2.84 (2.05–3.94) |