Analysis of Risk Factors for Multidrug-Resistant Organism (MDRO) Infections and Construction of a Risk Prediction Model in a Cancer Specialty Hospital

Br J Hosp Med (Lond). 2024 Oct 30;85(10):1-11. doi: 10.12968/hmed.2024.0353. Epub 2024 Oct 27.

Abstract

Aims/Background Patients receiving treatment in specialized cancer hospitals are particularly susceptible to multidrug-resistant organisms (MDRO) infections due to factors such as weakened immune systems caused by intensive treatments and prolonged hospital stays. This study aims to investigate the risk factors for MDRO infections in the cancer specialty hospital setting and to develop a corresponding risk prediction model. Methods Patients diagnosed with MDRO infections were selected for the MDRO infection group (n = 238), and those without for the non-MDRO infection group (n = 238). Non-parametric tests, chi-square tests, and multivariate logistic regression analysis were used to identify the primary risk factors for MDRO infections. With the aid of analysis utilizing R software 4.4.1 (R Foundation for Statistical Computing, Vienna, Austria), we developed a nomogram prediction model, which was evaluated using the receiver operating characteristics (ROC) curve, calibration curve, and decision curve analysis (DCA). Results Age, antibiotic application time, and central venous catheterization were independent risk factors for MDRO infection (p < 0.05). The constructed nomogram prediction model for patients with MDRO infection has a C-index of 0.8640. The ROC curve results showed that the prediction model has a specificity of 0.7700, a sensitivity of 0.8800, and an area under the curve (AUC) of 0.8800. Conclusion This study identifies significant risk factors for MDRO infections in a cancer specialty hospital setting and offers a clinically useful prediction model, which may aid in targeted preventive measures and optimization of antibiotics usage, thereby potentially reducing the incidence and impact of these infections.

Keywords: cancer specialty hospital; multidrug-resistant organisms; nomogram; prediction model; risk factors.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / drug therapy
  • Bacterial Infections / epidemiology
  • Cancer Care Facilities
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Drug Resistance, Multiple, Bacterial*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Nomograms*
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment / methods
  • Risk Factors

Substances

  • Anti-Bacterial Agents