Construction of A Predictive Model for Multidrug-resistant Organisms Carriage in HIV/AIDS Patients

Jingjing XU; Jiawei XIA; Le ZHANG; Xiao LU; Li LIU; Haiwen LI

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Jingjing XU, Jiawei XIA, Le ZHANG, Xiao LU, Li LIU, Haiwen LI. Construction of A Predictive Model for Multidrug-resistant Organisms Carriage in HIV/AIDS Patients[J]. Journal of Kunming Medical University.

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Jingjing XU, Jiawei XIA, Le ZHANG, Xiao LU, Li LIU, Haiwen LI. Construction of A Predictive Model for Multidrug-resistant Organisms Carriage in HIV/AIDS Patients[J]. Journal of Kunming Medical University.

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Construction of A Predictive Model for Multidrug-resistant Organisms Carriage in HIV/AIDS Patients

Jingjing XU¹,
Jiawei XIA¹,
Le ZHANG¹,
Xiao LU²,
Li LIU^{1
,
,},
Haiwen LI^{3
,
,}

1.
Department of Critical Care Medicine
2.
Department of Interventional Tuberculosis
3.
Department of Science，Education & Academic Affairs，The Third People's Hospital of Kunming，Kunming Yunnan 650041，China

Received Date: 2025-12-02

Abstract

Abstract

Objective To identify factors associated with multidrug-resistant organisms（MDRO） carriage in ICU AIDS patients, develop a risk prediction model, and assess its predictive performance. Methods A retrospective analysis was conducted on clinical data of 303 HIV/AIDS patients admitted to the ICU of Kunming Third People's Hospital from January 1, 2021 to April 30, 2025. Patients were stratified into two groups based on MDRO detection: N-MDRO group （n = 166） and MDRO group （n = 137）. Univariate and multivariate logistic regression analyses were used to identify factors affecting MDRO carriage in HIV/AIDS patients, construct a risk prediction model, and evaluate model performance using 5-fold cross-validation strategy. Results Among 303 HIV/AIDS patients, 137 cases tested positive for MDRO, with a detection rate of 45.21%. Ten factors identified through univariate analysis were incorporated into the logistic regression model, identifying ICU length of stay, mechanical ventilation support, antibiotic exposure type, and carbapenem antibiotics as significant predictive variables. Five - fold cross - validation demonstrated the model achieved mean accuracy of 0.787, sensitivity of 0.704, specificity of 0.879, and area under the receiver operating characteristic curve of 0.766. The calibration curve indicated a good fit between the predicted and actual values, with a Brier score of 0.199. Decision curve analysis showed curves exceeded the no - intervention reference line within the clinically reasonable thresholds. The clinical impact curve showed that the number of high - risk patients across all thresholds exceeded the sum of true - positive and false - positive cases, and when the threshold was greater than 0.2, the number of true - positive cases was higher than that of false - positive cases. Conclusion AIDS patients in ICU are at high risk for MDRO infection and transmission. The length of ICU stay, ventilator-assisted ventilation, the number of antibiotic exposure classes, and carbapenem use can serve as predictive indicators for the MDRO carriage risk model in AIDS patients.
- Multidrug-resistant organisms,
- Carriage,
- Influencing factors,
- Model,
- HIV/AIDS patients

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References(35)

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