Artificial Intelligence model to predict resistances in Gram-negative bloodstream infections

Abstract Artificial intelligence (AI) models are promising tools for predicting antimicrobial susceptibility in gram-negative bloodstream infections (GN-BSI). Single-center study on hospitalized patients with GN-BSI, over 7-year period, aimed to predict resistance to fluoroquinolones (FQ-R), third g...

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Main Authors: Cecilia Bonazzetti, Ettore Rocchi, Alice Toschi, Nicolas Riccardo Derus, Claudia Sala, Renato Pascale, Matteo Rinaldi, Caterina Campoli, Zeno Adrien Igor Pasquini, Beatrice Tazza, Armando Amicucci, Milo Gatti, Simone Ambretti, Pierluigi Viale, Gastone Castellani, Maddalena Giannella
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:npj Digital Medicine
Online Access:https://doi.org/10.1038/s41746-025-01696-x
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Summary:Abstract Artificial intelligence (AI) models are promising tools for predicting antimicrobial susceptibility in gram-negative bloodstream infections (GN-BSI). Single-center study on hospitalized patients with GN-BSI, over 7-year period, aimed to predict resistance to fluoroquinolones (FQ-R), third generation cephalosporins (3GC-R), beta-lactam/beta-lactamase inhibitors (BL/BLI-R) and carbapenems (C-R) was performed. Analyses were carried out within a machine learning framework, developed using the scikit-learn Python package. Overall, 2552 patients were included. Enterobacterales accounted for 85.5% of isolates, with E. coli, Klebsiella spp, and Proteus spp being most common. Distribution of resistance was FQ-R 48.6%, 3GC-R 40.1%, BL/BLI-R 29.9%, and C-R 16.9%. Models’ validation showed good performance predicting antibiotic resistance for all four resistance classes, with the best performance for C-R (AUC-ROC 0.921 ± 0.013). The developed pipeline has been made available ( https://github.com/EttoreRocchi/ResPredAI ), along with documentation for running the same workflow on a different dataset, to account for local epidemiology and clinical features.
ISSN:2398-6352