Chen Wei-Chuan, Wang Jiun-Ling, Chang Chi-Chuan, Lin Yusen Eason
Division of Teaching and Education, Teaching and Research Department, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.
Department of Pharmacy and Master Program, Tajen University, Yanpu Township, Pingtung 907101, Taiwan.
Microorganisms. 2025 Jan 7;13(1):101. doi: 10.3390/microorganisms13010101.
Vancomycin-intermediate (VISA) is a multi-drug-resistant pathogen of significant clinical concern. Various strains can cause infections, from skin and soft tissue infections to life-threatening conditions such as bacteremia and pneumonia. VISA infections, particularly bacteremia, are associated with high mortality rates, with 34% of patients succumbing within 30 days. This study aimed to develop predictive models for VISA (including VISA) bacteremia outcomes using data mining techniques, potentially improving patient management and therapy selection. We focused on three endpoints in patients receiving traditional vancomycin therapy: VISA persistence in bacteremia after 7 days, after 30 days, and patient mortality. Our analysis incorporated 29 risk factors associated with VISA bacteremia. The resulting models demonstrated high predictive accuracy, with 82.0-86.6% accuracy for 7-day VISA persistence in blood cultures and 53.4-69.2% accuracy for 30-day mortality. These findings suggest that data mining techniques can effectively predict VISA bacteremia outcomes in clinical settings. The predictive models developed have the potential to be applied prospectively in hospital settings, aiding in risk stratification and informing treatment decisions. Further validation through prospective studies is warranted to confirm the clinical utility of these predictive tools in managing VISA infections.
万古霉素中介耐药(VISA)是一种临床上备受关注的多重耐药病原体。多种菌株可引发感染,从皮肤和软组织感染到诸如菌血症和肺炎等危及生命的病症。VISA感染,尤其是菌血症,与高死亡率相关,34%的患者在30天内死亡。本研究旨在使用数据挖掘技术开发针对VISA(包括万古霉素中介耐药金黄色葡萄球菌)菌血症结局的预测模型,可能改善患者管理和治疗选择。我们聚焦于接受传统万古霉素治疗患者的三个终点:菌血症7天后、30天后的VISA持续存在情况以及患者死亡率。我们的分析纳入了29个与VISA菌血症相关的风险因素。所得模型显示出较高的预测准确性,血培养中7天VISA持续存在情况的预测准确率为82.0% - 86.6%,30天死亡率的预测准确率为53.4% - 69.2%。这些发现表明数据挖掘技术可在临床环境中有效预测VISA菌血症结局。所开发的预测模型有潜力在医院环境中前瞻性应用,有助于风险分层并为治疗决策提供依据。有必要通过前瞻性研究进行进一步验证,以确认这些预测工具在管理VISA感染方面的临床效用。