The duration of extensively drug-resistant bacteria (XDR) carriage depends on several factors for which the information can be difficult to recover. To determine whether past screening and clinical results of patients can predict the results of subsequent screening. In total, 256 patients were retrospectively included from 10 healthcare centres in France from January 2014 to January 2022. We created a predictive clearance score, ranging from –5 to +7, that included the number of XDR species and the type of resistance detected in the sample, as well as the time from the last positive sample, the number of previous consecutive negative samples, and obtaining at least one negative PCR result in the collection. This score could be used for the upcoming rectal screening of a patient carrying an XDR as soon as the last screening sample was negative. The negative predictive value was >99% for score ≤0. The median time to achieve XDR clearance was significantly shorter for a score of 0 (443 days (259–705)) than that based on previously published criteria. This predictive score shows high performance for the assessment of XDR clearance. Relative to previous guidelines, it could help to lift specific infection prevention and control measures earlier. Nevertheless, the decision should be made according to other factors, such as antimicrobial use and adherence to hand hygiene.

中文翻译：

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耐碳青霉烯类肠杆菌和耐万古霉素肠球菌筛查结果的预测评分

广泛耐药细菌 (XDR) 携带的持续时间取决于多个因素，而这些因素的信息可能难以恢复。确定患者过去的筛查和临床结果是否可以预测后续筛查的结果。 2014 年 1 月至 2022 年 1 月期间，总共纳入了来自法国 10 个医疗中心的 256 名患者。我们创建了一个预测清除评分，范围从 –5 到 +7，其中包括 XDR 物种的数量以及在患者中检测到的耐药类型。样本，以及距最后一个阳性样本的时间、之前连续阴性样本的数量，以及在集合中获得至少一个阴性 PCR 结果。一旦最后一次筛查样本呈阴性，该分数即可用于即将对携带 XDR 的患者进行直肠筛查。对于分数≤0，阴性预测值>99%。分数为 0 时，达到 XDR 清除的中位时间（443 天（259-705））比根据之前发布的标准要短得多。该预测分数显示了 XDR 清除率评估的高性能。相对于之前的指导方针，这有助于更早地取消具体的感染防控措施。尽管如此，应根据其他因素做出决定，例如抗菌药物的使用和手部卫生的遵守情况。