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 Sun1 1Department of Clinical Laboratory, Urumqi Friendship Hospital, Urumqi City, Xinjiang Uygur Autonomous Region, People’s Republic of China; 2School of Basic Medicine, Xinjiang Medical University, Urumqi City, Xinjiang Uygur Autonomous Region, People’s Republic of China; 3The second Medical College, Xinjiang Medical University, Laboratory Class, Karamay City, Xinjiang Uygur Autonomous Region, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hong Sun, Urumqi Friendship Hospital, Tianshan District, Urumqi City, Xinjiang Uygur Autonomous Region, 830049, People’s Republic of China, Tel +86-13899816208, Email [email protected]: 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: systemic inflammation response index, systemic inflammatory immune index, extended-spectrum β-lactamase, Klebsiella pneumoniae, prediction of drug resistance