How to predict ESBL BSI (part 2)

A month ago (April 11) I blogged on the difficulties in predicting the presence of ESBL-producing bacteria as a cause of infection at the time antibiotics must be started. Wouter Rottier (PhD student) developed 2 prediction rules (for community-onset and hospital-onset infection), that seem to do better than current guideline recommendations (especially for reducing unnecessary carbapenem use). Another PhD student (Tim Deelen) now wants to validate these rules, globally. The “crowd-funding study approach” worked and sites across the world joined us….

Based on the study (see here) we created  an eCRF for the scores at the day empiric treatment starts (5 minutes work) and to enter culture results 5 days later (another 2 minutes). We aim for 20,000 episodes for validation!

After the blog the study upgraded from a small European study to an intercontinental study, with the initiation of a center in Japan! As of now, the study is running in the Netherlands, Sweden, Spain, Italy, Germany, Japan and Switzerland, with sites in Serbia, Montenegro and the United Kingdom ready to start.

As of the 15th of May, there have been 1,070 inclusions; 18% being hospital-onset infections. In the chart a crude overview of the empiric therapy used in community-onset infections (might be some overlap and patients getting double therapy, though interesting anyway).


It would be great if we can – in the end – determine accuracy at country level, resistance level, continent level. We hope this bacterial study goes viral and that many physicians join. We will keep you updated regularly, with (hopefully) interesting preliminary data. But in the end, we hope that these prediction rules improve empiric antibiotic prescription.

Bottomline: you all can join the “ESBL-prediction movement”. For more details (e.g., coauthor rules) contact Tim Deelen:

telephone +31 88 7569616

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