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Article

Bedside Risk Scoring for Carbapenem-Resistant Gram-Negative Bacterial Infections in Patients with Hematological Malignancies

by
Sare Merve Başağa
1,
Ayşegül Ulu Kılıç
2,
Zeynep Ture
3,*,
Gökmen Zararsız
4 and
Serra İlayda Yerlitaş
4
1
Department of Infectious Diseases, Eyüp Sultan State Hospital, 34654 İstanbul, Türkiye
2
Department of Infectious Diseases, Faculty of Medicine, Erciyes University, 38039 Kayseri, Türkiye
3
Private Gürlife Hospital, Infectious Diseases Clinic, 26010 Eskişehir, Türkiye
4
Department of Biostatistics, School of Medicine, Erciyes University, 38039 Kayseri, Türkiye
*
Author to whom correspondence should be addressed.
Infect. Dis. Rep. 2025, 17(4), 92; https://doi.org/10.3390/idr17040092 (registering DOI)
Submission received: 5 June 2025 / Revised: 19 July 2025 / Accepted: 29 July 2025 / Published: 1 August 2025

Abstract

Background/Objectives: This study aimed to create a ‘carbapenem resistance score’ with the risk factors of carbapenem-resistant Gram-negative bacterial infections (GNBIs) in patients with hematological malignancies. Methods: Patients with carbapenem-resistant and susceptible GNBIs were included in this study and compared in terms of risk factors. Three models of “carbapenem resistance risk scores” were created with statistically significant variables. Results: The study included 154 patients with hospital-acquired GNBIs, of whom 64 had carbapenem-resistant GNBIs and 90 had carbapenem-susceptible GNBIs. Univariate and multivariate analyses identified several statistically significant risk factors for carbapenem resistance, including transfer from another hospital or clinic (p = 0.038), prior use of antibiotics like fluoroquinolones (p = 0.009) and carbapenems (p = 0.001), a history of carbapenem-resistant infection in the last six months (p < 0.001), rectal Klebsiella pneumoniae colonization (p < 0.001), hospitalization for ≥30 days (p = 0.001), and the presence of a urinary catheter (p = 0.002). Notably, the 14-day mortality rate was significantly higher in the carbapenem-resistant group (p < 0.001). Based on these findings, three risk-scoring models were developed. Common factors in all three models were fluoroquinolone use in the last six months, rectal K. pneumoniae colonization, and the presence of a urinary catheter. The fourth variable was transfer from another hospital (Model 1), a history of carbapenem-resistant infection (Model 2), or hospitalization for ≥30 days (Model 3). All models demonstrated strong discriminative power (AUC for Model 1: 0.830, Model 2: 0.826, Model 3: 0.831). For all three models, a cutoff value of >2.5 was adopted as the threshold to identify patients at high risk for carbapenem resistance, a value which yielded high positive and negative predictive values. Conclusions: This study successfully developed three practical risk-scoring models to predict carbapenem resistance in patients with hematological malignancies using common clinical risk factors. A cutoff score of >2.5 proved to be a reliable threshold for identifying high-risk patients across all models, providing clinicians with a valuable tool to guide appropriate empirical antibiotic therapy.
Keywords: carbapenem resistance score; hematological malignancies; carbapenem resistance; Gram-negative infections; bedside score carbapenem resistance score; hematological malignancies; carbapenem resistance; Gram-negative infections; bedside score

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MDPI and ACS Style

Başağa, S.M.; Ulu Kılıç, A.; Ture, Z.; Zararsız, G.; Yerlitaş, S.İ. Bedside Risk Scoring for Carbapenem-Resistant Gram-Negative Bacterial Infections in Patients with Hematological Malignancies. Infect. Dis. Rep. 2025, 17, 92. https://doi.org/10.3390/idr17040092

AMA Style

Başağa SM, Ulu Kılıç A, Ture Z, Zararsız G, Yerlitaş Sİ. Bedside Risk Scoring for Carbapenem-Resistant Gram-Negative Bacterial Infections in Patients with Hematological Malignancies. Infectious Disease Reports. 2025; 17(4):92. https://doi.org/10.3390/idr17040092

Chicago/Turabian Style

Başağa, Sare Merve, Ayşegül Ulu Kılıç, Zeynep Ture, Gökmen Zararsız, and Serra İlayda Yerlitaş. 2025. "Bedside Risk Scoring for Carbapenem-Resistant Gram-Negative Bacterial Infections in Patients with Hematological Malignancies" Infectious Disease Reports 17, no. 4: 92. https://doi.org/10.3390/idr17040092

APA Style

Başağa, S. M., Ulu Kılıç, A., Ture, Z., Zararsız, G., & Yerlitaş, S. İ. (2025). Bedside Risk Scoring for Carbapenem-Resistant Gram-Negative Bacterial Infections in Patients with Hematological Malignancies. Infectious Disease Reports, 17(4), 92. https://doi.org/10.3390/idr17040092

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