2174. Development and Validation of a Clinical Prediction Model for Community-Onset Pneumonia caused by Extended-Spectrum Beta-lactamase-Producing Enterobacteriaceae

Abstract

Abstract Background The study aims to identify specific risk factors associated with developing pneumonia cause by ESBL producing organisms and develop a Clinical scoring model base on the risk factors identified to be able to provide guidance on appropriate empiric antibiotic therapy Methods We conducted a single-center retrospective cohort study in a tertiary hospital on Pasig City, Philippines including 150 patients admitted with Community onset Pneumonia from 2018 to 2019 Baseline Characteristics Independent variables included in the study Results Among 150 patients admitted with Community onset Pneumonia, 70.2% their respiratory isolates were K. Pneumoniae followed be E. coli at 14.57%. The Total ESBL rate among all the respiratory isolate was 45.3%. Univariate analysis of all the risk factors showed significant statistical difference in female Sex (OR 0.49; 5% CI: 0.26-0.96), Charlson Score (OR 26.00; 95% CI: 10.66-63.39), Recent Hospitalization (OR: 29.35; 95% CI: 11.53-74.46), Recent Antibiotic Use (OR 84.49; 95% CI: 28.66 – 251.87), Prior History of ESBL (OR: 57.14; 95% CI: 12.96 – 525.01), and Frequent ED visits (OR:45.88; 95% CI; 15.92 – 132.23). Multivariate analysis was done to generate the final model. The results shows that Charlson Score (OR 11.86, 95%CI: 2.55 – 55.18, p value 0.002), Recent Antibiotic Use (OR: 31.09, 95%CI: 5.36-180.44, p value < 0.001). and Frequent ED visits (OR 6.52; 95% CI 1.04-41.07) were found to be significant predictor of ESBL. The final model of the three risk factors has a performance AU ROC Curve of 0.9780 at distinguishing between the positive and negative samples. Sensitivity, Specificity, PPV, NPV and ROC area of each of the variables included in the final model Conclusion The results of this study suggest a simple and easy-to-use prediction model to predict Community-onset pneumonia caused by ESBL-producing Enterobacteriaceae. Disclosures All Authors: No reported disclosures.