肠球菌血流感染患者预后危险因素及列线图预测模型OA

Objective:Enterococci have emerged as important nosocomial pathogens worldwide,capable of causing a wide range of infections,among which bloodstream infection is particularly challenging.In clinical practice,there is a lack of tools that can promptly integrate multidimensional clinical variables to provide rapid and visualized individualized prognostic risk assessment.This study aims to analyze the clinical characteristics and prognostic risk factors of patients with enterococcal bloodstream infection,develop and validate a nomogram prediction model,and provide guidance for clinical management and treatment. Methods:Clinical data of 128 patients with enterococcal bloodstream infection admitted to the Inner Mongolia Autonomous Region People's Hospital were retrospectively collected.Multivariate logistic regression analysis was performed to identify risk factors for poor prognosis.A nomogram prediction model was constructed and validated using R software(version 4.0.3). Results:Use of corticosteroids(OR=3.575,95％CI 1.049 to 12.180,P=0.042),presence of respiratory failure(OR=2.793,95％CI 1.042 to 7.487,P=0.041),and age≥65 years(OR=2.840,95％CI 1.184 to 6.816,P=0.019)were identified as independent risk factors for poor prognosis in bloodstream infection.A nomogram model was constructed based on these three factors and subsequently validated.The calibration curve showed good agreement with the standard curve,indicating good calibration of the model.The area under the receiver operating characteristic curve was 0.757(95％CI 0.674 to 0.840),demonstrating good discriminative ability. Conclusion:Corticosteroid use,respiratory failure,and age≥65 years are independent risk factors for poor prognosis in patients with enterococcal bloodstream infection.The nomogram model developed in this study shows good discrimination and calibration.