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. 2025 Feb 12:18:2153-2168.
doi: 10.2147/JIR.S506046. eCollection 2025.

Predicting Drug Resistance: The Use of Novel Inflammatory Markers in Identifying ESBL-Producing Klebsiella pneumoniae

Xin Ma #  1   2 , Jing Yuan #  1 , Lihong Tang #  1 , Xue Chen #  1 , Yan Zhou  3 , Ningna Wang  1 , Hong Sun  1
Affiliations

Predicting Drug Resistance: The Use of Novel Inflammatory Markers in Identifying ESBL-Producing Klebsiella pneumoniae

Xin Ma et al. J Inflamm Res. .

Abstract

Purpose: To explore the association of the Systemic Inflammatory Response Index (SIRI) and Systemic Inflammatory Immunity Index (SII) with extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae (K. pneumoniae) and its resistance prediction.

Methods: A total of 425 patients with K. pneumoniae infections were included in the study. Data on general clinical characteristics and relevant laboratory indicators were collected. The patients were divided into ESBL-producing and non-ESBL-producing groups based on the presence of ESBLs. Logistic regression analysis was used to analyze the risk factors associated with ESBL-producing K. pneumoniae. The receiver operating characteristic (ROC) curve was employed to assess the predictive efficacy of SIRI and SII for ESBL-producing K. pneumoniae and its resistance to antibiotics.

Results: SIRI and SII levels in the ESBL-producing group were significantly higher than those in the non-ESBL-producing group. Logistic regression analysis showed that the odds ratios for SIRI and SII were 1.092 and 1.158, respectively, with 95% confidence intervals of 1.001-1.115 and 1.015-1.204, respectively. The critical values for predicting ESBL-producing K. pneumoniae were 1.067 for SIRI and 579.68 for SII, with area under the curve (AUC) values of 0.725 and 0.723, respectively. The AUC values for predicting resistance of ESBL-producing K. pneumoniae to piperacillin (PIP), amoxicillin/clavulanate (AMC), and cefazolin (CZO) were 0.614, 0.657, and 0.648 for SIRI, and 0.675, 0.613, and 0.625 for SII, respectively.

Conclusion: SIRI and SII are significantly associated with the risk of ESBL-producing K. pneumoniae and can be used to predict a patient's risk of infection with this organism. Additionally, SIRI and SII accurately predict the resistance of ESBL-producing K. pneumoniae to PIP, AMC, and CZO antibiotics.

Keywords: Klebsiella pneumoniae; extended-spectrum β-lactamase; prediction of drug resistance; systemic inflammation response index; systemic inflammatory immune index.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Distribution of specimens with 425 strains of K. pneumoniae.
Figure 2
Figure 2
Comparison of different inflammatory indexes in two groups, (A) Comparative statistics of WBC in two groups, (B) Comparative statistics of IL-6 in two groups, (C) Comparative statistics of PCT in two groups, (D) Comparative statistics of CRP in two groups, (E) Comparative statistics of SII in two groups, (F) Comparative statistics of SIRI in two groups.
Figure 3
Figure 3
Linear analysis of SIRI and SII versus WBC, IL-6, PCT, and CRP, (A) linear analysis of SIRI versus WBC, (B) linear analysis of SIRI versus CRP, (C) linear analysis of SIRI versus IL-6, (D) linear analysis of SIRI versus PCT, (E) linear analysis of SII versus WBC, (F) linear analysis of SII versus CRP, (G) linear analysis of SII versus IL-6, (H) linear analysis of SII versus PCT.
Figure 4
Figure 4
SIRI and SII accurately predict ESBL-producing K. pneumoniae.
Figure 5
Figure 5
SIRI and SII accurately predict PIP, AMC, and CZO resistance in ESBL-producing K. pneumoniae, (A) ROC analysis of resistance of ESBL-producing K. pneumoniae to PIP antimicrobials by SIRI, SII, LYM, and CHOL, (B) ROC analysis of resistance of ESBL-producing K. pneumoniae to AMC antimicrobials by SIRI, SII, LYM, and CHOL, (C) ROC analysis of resistance of ESBL-producing K. pneumoniae to CZO antimicrobials by SIRI, SII, LYM, and CHOL, (D) ROC analysis of resistance of ESBL-producing K. pneumoniae to CAZ antimicrobials by SIRI, SII, LYM, and CHOL, (E) ROC analysis of resistance of ESBL-producing K. pneumoniae to CIP antimicrobials by SIRI, SII, LYM, and CHOL, (F) ROC analysis of resistance of ESBL-producing K. pneumoniae to ATM antimicrobials by SIRI, SII, LYM, and CHOL, (G) ROC analysis of resistance of ESBL-producing K. pneumoniae to SAM antimicrobials by SIRI, SII, LYM, and CHOL, (H) ROC analysis of resistance of ESBL-producing K. pneumoniae to LVX antimicrobials by SIRI, SII, LYM, and CHOL.
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References

    1. Ashurst JV, Dawson A. Klebsiella Pneumonia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. - PubMed
    1. Hussein RA, Al-Kubaisy SH, Al-Ouqaili MTS. The influence of efflux pump, outer membrane permeability and β-lactamase production on the resistance profile of multi, extensively and pandrug resistant Klebsiella pneumoniae. J Infect Public Health. 2024;17(11):102544. doi:10.1016/j.jiph.2024.102544 - DOI - PubMed
    1. Bourjilat F, Bouchrif B, Dersi N, et al. Emergence of extended-spectrum beta-lactamases-producing Escherichia coli in community-acquired urinary infections in Casablanca, Morocco. J Infect Dev Ctries. 2011;5(12):850–855. doi:10.3855/jidc.1490 - DOI - PubMed
    1. Coque TM, Oliver A, Pérez-Díaz JC, et al. Genes Encoding TEM-4, SHV-2, and CTX-M-10 extended-spectrum β-lactamases are carried by multiple Klebsiella pneumoniae clones in a single hospital (Madrid, 1989 to 2000). Antimicrob Agents Chemother. 2002;46(2):500–510. doi:10.1128/AAC.46.2.500-510.2002 - DOI - PMC - PubMed
    1. Chopra T, Marchaim D, Johnson PC, et al. Risk factors for bloodstream infection caused by extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae: a focus on antimicrobials including cefepime. Am J Infect Control. 2015;43(7):719–723. doi:10.1016/j.ajic.2015.02.030 - DOI - PubMed

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