SciELO - Scientific Electronic Library Online

 
vol.37 número6Estudio multicéntrico retrospectivo de los aspectos epidemiológicos, clínicos y terapéuticos de la enfermedad de Kawasaki en niños de PanamáCaracterísticas clínicas de la neurocisticercosis en un hospital referencial del norte del Perú. 2016-2018 índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Revista

Articulo

Indicadores

Links relacionados

  • En proceso de indezaciónCitado por Google
  • No hay articulos similaresSimilares en SciELO
  • En proceso de indezaciónSimilares en Google

Compartir


Revista chilena de infectología

versión impresa ISSN 0716-1018

Resumen

NINO, Sebastián Fernando et al. Development and validation of a diagnostic model of antimicrobial resistance by extended-spectrum beta-lactamases in community-acquired urinary tract infections. How to adjust the prediction in variable outcome prevalences? The usefulness of contracting predictors with LASSO regression. Rev. chil. infectol. [online]. 2020, vol.37, n.6, pp.683-689. ISSN 0716-1018.  http://dx.doi.org/10.4067/S0716-10182020000600683.

Background:

In the case of community-acquired urinary tract infection, the identification of Enterobacteriaceae with extended spectrum beta-lactamases (ESBL) can optimize treatment, control and follow-up strategies, however the effect of variable prevalences of this resistance pattern has affected the external validity of this type of models.

Aim:

To develop a diagnostic predictive model that adjusts the prediction error in variable prevalences using the LASSO regression.

Methods:

A diagnostic predictive model of community-acquired urinary tract infection by infection by ESBL producing Enterobacteriaceae was designed. A cross-sectional study was used for both construction and validation. To assess the effect of the variable prevalence of the outcome, the validation was performed with a population in which the proportion of isolates with this resistance mechanism was lower, the participants were adult patients who consulted the emergency services of two medium-level hospital institutions. complexity of the city of Medellin. To adjust for the effect of an environment with a lower proportion of antimicrobial resistance, we used the contraction of predictors by LASSO regression.

Results:

303 patients were included for the construction of the model, six predictors were evaluated and validation was carried out in 220 patients.

Conclusion:

The adjusted model with LASSO regression favored the external validity of the model in populations with a proportion of ESBL producing isolates in urine culture of outpatients between 11 and 16%. This study provides criteria for early isolation when predictors are present in populations with proportions of resistance in ambulatory urine cultures close to 15% and proposes a methodology for the adjustment of errors in the design of prediction models for antimicrobial resistance.

Palabras clave : logistic models; beta-lactam resistance; urinary tract infections.

        · resumen en Español     · texto en Español     · Español ( pdf )