Journal 2026 Vol.27 No.1
Development of a Clinical Prediction Tool for Detecting Hospital-acquired Extended-spectrum β-lactamase-Producing Gram-Negative Bacteria in Pediatric Patients
Esther Ann B. Nacita, M.D., Carmina A. Delos Reyes, M.D.

Abstract
Objective: Extended-spectrum β-lactamase (ESBL)-producing bacteria are important causes of hospital-acquired infections. While prediction tools exist for adults, limited data are available in children. This study aimed to develop a simple tool to identify pediatric patients at risk for ESBL-producing bacteria.
Methodology: A retrospective study was conducted in a tertiary government hospital involving pediatric inpatients. Risk factors were analyzed using logistic regression to derive a scoring system based on independent predictors. Model performance was evaluated using the area under the curve, the Hosmer–Lemeshow test and internal validation.
Results: Among 389 pediatric patients, three risk factors were independently associated with ESBL production: prior cephalosporin use within 3 months, mechanical ventilation, and indwelling urinary catheterization. These were incorporated into a 4-point scoring system. The model demonstrated moderate discrimination (AUC 0.70, Hosmer-Lemeshow p=0.0805) and correctly classi!ed 74.8% cases as low (0-1) and high risk (2-4). Bootstrapped validation accuracy was 63.2%, showing good internal stability.
Conclusion: This practical tool, based on readily available clinical data, may aid early risk strati!cation for ESBL production and guide antibiotic therapy in children, supporting antimicrobial stewardship. Prospective validation in diverse pediatric populations is recommended.

KEYWORDS: Extended-spectrum β-lactamase (ESBL), clinical prediction tool, hospital-acquired infection, antimicrobial stewardship
https://doi.org/10.56964/pidspj20262701006
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