Comparison of the performance of a clinical classification tree versus clinical gestalt in predicting sepsis with extended-spectrum beta-lactamase-producing gram-negative rods

Hayden L Smith; Mohamed A Elfeki; Dana Lowry; Rebecca Sabates; Molly Ropte; Katherine R Sittig; Stephanie Finch; Kristina Braun; William Pruett; Aaron Wasson; Kenna Fischman; Jennifer Peterson; Rossana Rosa

doi:10.1017/ash.2021.253

Comparison of the performance of a clinical classification tree versus clinical gestalt in predicting sepsis with extended-spectrum beta-lactamase-producing gram-negative rods

Antimicrob Steward Healthc Epidemiol. 2022 Mar 7;2(1):e35. doi: 10.1017/ash.2021.253. eCollection 2022.

Authors

Hayden L Smith¹, Mohamed A Elfeki^{1

2}, Dana Lowry^{1

2}, Rebecca Sabates^{1

2}, Molly Ropte^{1

2}, Katherine R Sittig^{1

2}, Stephanie Finch^{1

2}, Kristina Braun^{1

2}, William Pruett^{1

2}, Aaron Wasson^{1

2}, Kenna Fischman^{1

2}, Jennifer Peterson³, Rossana Rosa^#^{2

4}

Affiliations

¹ Iowa Methodist Medical Center, UnityPoint Health-Des Moines, Des Moines, Iowa.
² Internal Medicine Department, University of Iowa, Des Moines, Iowa.
³ Des Moines University College of Osteopathic Medicine, Des Moines, Iowa.
⁴ Infectious Diseases Service, UnityPoint Health-Des Moines, Des Moines, Iowa.

^# Contributed equally.

Abstract

A clinical decision tree was developed using point-of-care characteristics to identify patients with culture-proven sepsis due to extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE). We compared its performance with the clinical gestalt of emergency department (ED) clinicians and hospital-based clinicians. The developed tree outperformed ED-based clinicians but was comparable to inpatient-based clinicians.