{"doi":"10.1093/jtm/taad028","title":"Development of a prediction model for the acquisition of extended spectrum beta-lactam-resistant organisms in U.S. international travellers","abstract":"BACKGROUND: Extended spectrum beta-lactamase producing Enterobacterales (ESBL-PE) present a risk to public health by limiting the efficacy of multiple classes of beta-lactam antibiotics against infection. International travellers may acquire these organisms and identifying individuals at high risk of acquisition could help inform clinical treatment or prevention strategies. METHODS: We used data collected from a cohort of 528 international travellers enrolled in a multicentre US-based study to derive a clinical prediction rule (CPR) to identify travellers who developed ESBL-PE colonization, defined as those with new ESBL positivity in stool upon return to the United States. To select candidate features, we used data collected from pre-travel and post-travel questionnaires, alongside destination-specific data from external sources. We utilized LASSO regression for feature selection, followed by random forest or logistic regression modelling, to derive a CPR for ESBL acquisition. RESULTS: A CPR using machine learning and logistic regression on 10 features has an internally cross-validated area under the receiver operating characteristic curve (cvAUC) of 0.70 (95% confidence interval 0.69-0.71). We also demonstrate that a four-feature model performs similarly to the 10-feature model, with a cvAUC of 0.68 (95% confidence interval 0.67-0.69). This model uses traveller's diarrhoea, and antibiotics as treatment, destination country waste management rankings and destination regional probabilities as predictors. CONCLUSIONS: We demonstrate that by integrating traveller characteristics with destination-specific data, we could derive a CPR to identify those at highest risk of acquiring ESBL-PE during international travel.","journal":"Journal of Travel Medicine","year":2023,"id":344039,"datarank":0.3958585994422889,"base_score":2.639057329615259,"endowment":2.639057329615259,"self_citation_contribution":0.3958585994422889,"citation_network_contribution":0.0,"self_endowment_contribution":0.3958585994422889,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9621,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":477756,"name":"Colin J. Worby","orcid":"0000-0002-9132-7249","position":1,"is_corresponding":false},{"id":754014,"name":"Melissa Pender","orcid":null,"position":2,"is_corresponding":false},{"id":455317,"name":"Ben J. Brintz","orcid":"0000-0003-4695-0290","position":3,"is_corresponding":false},{"id":108468,"name":"Edward T. Ryan","orcid":"0009-0005-0169-394X","position":4,"is_corresponding":false},{"id":1046802,"name":"Sushmita Sridhar","orcid":null,"position":5,"is_corresponding":false},{"id":109064,"name":"Elizabeth Oliver","orcid":"0000-0002-3614-4976","position":6,"is_corresponding":false},{"id":109068,"name":"Jason B. Harris","orcid":"0000-0003-3642-5126","position":7,"is_corresponding":false},{"id":109066,"name":"Sarah E. Turbett","orcid":"0000-0002-3603-8110","position":8,"is_corresponding":false},{"id":441608,"name":"Sowmya R. Rao","orcid":"0000-0003-3869-8320","position":9,"is_corresponding":false},{"id":29020,"name":"Ashlee M. Earl","orcid":"0000-0001-7857-9145","position":10,"is_corresponding":false},{"id":62201,"name":"Regina C. LaRocque","orcid":"0000-0003-4558-0339","position":11,"is_corresponding":false},{"id":352714,"name":"Daniel T. Leung","orcid":"0000-0001-8401-0801","position":12,"is_corresponding":false},{"id":901972,"name":"D. Garrett Brown","orcid":"0000-0001-8779-7048","position":0,"is_corresponding":true}],"reference_count":48,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:11:26.556051Z","pmid":"36864572","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}