How to predict ESBL (part 3)

Six weeks ago I introduced the ESBL-predict study that Tim Deelen from our group coordinates. Every hospital in the world can participate through a user-friendly electronic CRF (in a secured environment). My blog-invitation to particpate worked and some sites already started. In June >1,000 episodes were entered! Here is a short update and info for those that want to join. 

In short: Wouter Rottier (PhD student) developed 2 prediction rules (for community-onset and hospital-onset infection) for predicting the presence of ESBL-producing bacteria as a cause of infection at the time antibiotics must be started. As these rules did better than current guideline recommendations (especially for reducing unnecessary carbapenem use) when derived, external validation is needed. So, 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). Everyone can participate and we aim for 20,000 episodes!

In June we had 1,100 inclusions, making a new total of 2,192. Some hospitals have finished data collection, such as Ryhov County Hospital (Sweden) and Amphia Hospital, Breda (the Netherlands).

It’s interesting to see the differences in blood culture positivity between hospitals, ranging from 14% to 36%. Of the 1,661 completed blood cultures, 432 were positive (26%). Differences between hospitals (and countries) might reflect differences in blood culture practices: a lower threshold for diagnostics will yield more negative culture results (by some hospital CEOs considered as a waste of money, see here).

So far, we have 51 blood cultures with third-generation cephalosporin resistant Enterobacteriaciae (3.1% of all BC, 11.8% of all positive BC ), and six with carbapenem resistant Enterobacteriaceae.

Bottomline: you all can join the “ESBL-prediction movement”. For more details (e.g., coauthor rules) contact Tim Deelen:  j.w.t.deelen@umcutrecht.nl

telephone +31 88 7569616

I think he enjoyes a short break this week, dreaming of an overloaded mailbox on Monday.

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