[High-Risk Factors of Multidrug-Resistant Organism Infection in Patients with Acute Leukemia and Construction of Nomogram Prediction Mode].
To explore the high-risk factors of multidrug-resistant organism (MDRO) infection in patients with acute leukemia, and to construct a nomogram prediction model.
A total of 200 patients with acute leukemia admitted to the Department of Hematology, the First Affiliated Hospital of Air Force Military Medical University from January 2024 to January 2025 were enrolled in this study. The specimens of the enrolled were cultured. According to the presence or absence of MDRO infection, the patients were divided into the MDRO group (n=32) and the non-MDRO group (n=168). Clinical data of the two groups were collected and compared. Logistic regression analysis was used to analyze the influencing factors of MDRO infection in patients with acute leukemia. A nomogram model was constructed according to the selected influencing factors. The predictive accuracy of the model was evaluated by receiver operating characteristic (ROC) curve and calibration curve.
Of the 32 patients complicated with MDRO infection, a total of 35 pathogenic strains were isolated. The top three pathogens were methicillin-resistant coagulase-negative staphylococci (14 strains, 40.00%), Klebsiella pneumoniae (7 strains, 20.00%), and extended-spectrum β-lactamase-producing Escherichia coli (6 strains, 17.14%). Multivariate logistic regression analysis showed that indwelling drainage tube (OR =4.551), after hematopoietic stem cell transplantation (HSCT) (OR =3.216), use of antibiotics within 90 days of infection (OR =5.192), and diabetes mellitus (OR =5.083) were independent risk factors for MDRO infection in patients with acute leukemia (all P < 0.05). The ROC curve results under the nomogram model showed that the AUC was 0.736 (95%CI : 0.644-0.828), the sensitivity was 0.792, and the specificity was 0.739. The calibration curve and Hosmer-Lemeshow goodness-of-fit test showed χ2=0.973, P =0.615, indicating good fitting performance and favorable predictive accuracy of the model. The decision curve analysis demonstrated that the nomogram possessed high clinical utility in predicting the risk of MDRO infection in patients with acute leukemia.
Indwelling drainage tube, use of antibiotics within 90 days after HSCT, and diabetes mellitus are risk factors for MDRO infection in patients with acute leukemia, and their predictive value is high.
A total of 200 patients with acute leukemia admitted to the Department of Hematology, the First Affiliated Hospital of Air Force Military Medical University from January 2024 to January 2025 were enrolled in this study. The specimens of the enrolled were cultured. According to the presence or absence of MDRO infection, the patients were divided into the MDRO group (n=32) and the non-MDRO group (n=168). Clinical data of the two groups were collected and compared. Logistic regression analysis was used to analyze the influencing factors of MDRO infection in patients with acute leukemia. A nomogram model was constructed according to the selected influencing factors. The predictive accuracy of the model was evaluated by receiver operating characteristic (ROC) curve and calibration curve.
Of the 32 patients complicated with MDRO infection, a total of 35 pathogenic strains were isolated. The top three pathogens were methicillin-resistant coagulase-negative staphylococci (14 strains, 40.00%), Klebsiella pneumoniae (7 strains, 20.00%), and extended-spectrum β-lactamase-producing Escherichia coli (6 strains, 17.14%). Multivariate logistic regression analysis showed that indwelling drainage tube (OR =4.551), after hematopoietic stem cell transplantation (HSCT) (OR =3.216), use of antibiotics within 90 days of infection (OR =5.192), and diabetes mellitus (OR =5.083) were independent risk factors for MDRO infection in patients with acute leukemia (all P < 0.05). The ROC curve results under the nomogram model showed that the AUC was 0.736 (95%CI : 0.644-0.828), the sensitivity was 0.792, and the specificity was 0.739. The calibration curve and Hosmer-Lemeshow goodness-of-fit test showed χ2=0.973, P =0.615, indicating good fitting performance and favorable predictive accuracy of the model. The decision curve analysis demonstrated that the nomogram possessed high clinical utility in predicting the risk of MDRO infection in patients with acute leukemia.
Indwelling drainage tube, use of antibiotics within 90 days after HSCT, and diabetes mellitus are risk factors for MDRO infection in patients with acute leukemia, and their predictive value is high.