OBJECTIVE To analyze the epidemiological characteristics and risk factors of hospitalized patients with carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection, and to construct a risk prediction model for poor prognosis events.

METHODS A total of 112 hospitalized patients with CRE bloodstream infection from Jining No. 1 People′s Hospital between Jan. 2022 and Dec. 2024 were selected, including 55 patients in the improved prognosis group and 57 patients in the poor prognosis group. The department distribution, pathogen composition and drug resistance were analyzed. Important risk factors for poor prognosis events in hospitalized patients were screened through univariate analysis. Logistic regression was used to determine risk factors, and a nomogram risk prediction model was constructed. The receiver operating characteristic (ROC) curve was plotted to evaluate the prediction ability of the model.

RESULTS The most common department with CRE detected was the intensive care unit (ICU), and the most frequently detected pathogens were Klebsiella pneumoniae and Escherichia coli. CRE strains for bloodstream infection were widely resistant to commonly used clinical antibacterial agents, but more sensitive to tigecycline, colistin and amikacin. Multivariate analysis results showed that ICU admission, tracheal intubation, blood purification, surgical history and history of carbapenem use were risk factors for poor prognosis events in patients with CRE bloodstream infection. Based on these risk factors, a poor prognosis risk prediction model was constructed with an area under the ROC curve (AUC) of 0.871 (95%CI: 0.802-0.940), a sensitivity of 82.46% and a specificity of 87.27%.

CONCLUSION The risk prediction model for poor prognosis events in hospitalized patients with CRE bloodstream infection has good prediction performance and can provide a scientific basis for early identification and precise intervention in high-risk patients.