Journal article
Personalized Antibiogram: A Novel Multi-Task Machine Learning Framework for Simultaneous Prediction of Antimicrobial Resistance Profile with Enhanced Detection of Carbapenem Resistance in Enterobacteriaceae
Clinical infectious diseases, PMID 9203213
01/17/2026
DOI: 10.1093/cid/ciag027
PMID: 41546531
Appears in UI Libraries Support Open Access
Abstract
Conventional hospital antibiograms summarize aggregated resistance rates, limiting their utility for individualized antimicrobial selection. Existing statistical and machine learning models predict each phenotype separately, ignoring correlations among resistance profiles. We developed novel multi-task extreme gradient boosting (XGBoost) models utilizing structured data in electronic health records (EHRs) to predict resistance to eight antimicrobial classes simultaneously and evaluated their performance within the Veterans Health Administration (VHA).
We conducted a retrospective multicenter study of Escherichia coli and Klebsiella spp. isolates collected at 127 hospitals and >1,400 clinics from January 2017 to September 2024. Data from January 2017 to September 2023 were used for model development, while data from October 2023 to September 2024 were used for simulated prospective testing. Model performances were compared to hospital antibiograms and single-target XGBoost models.
The training cohort included 536,252 E. coli and 246,898 Klebsiella spp. isolates; the test cohort included 75,138 and 38,015 isolates, respectively. On the test data, the multi-task model achieved overall areas under the receiver operating characteristic curve (AUROCs) of 0.779 (E. coli) and 0.810 (Klebsiella spp.), with good to excellent per-class performance (AUROCs range: 0.743-0.847). A multi-task approach improved calibration and decreased false negative rates for carbapenem resistance, while predicting individualized resistance probabilities for all target antimicrobials simultaneously ("personalized antibiograms").
A multi-task XGBoost framework can accurately predict individualized resistance profiles for common Gram-negative pathogens, outperforming conventional antibiograms and single-target models. Personalized antibiograms may enhance the selection of empiric therapy, including the detection of carbapenem resistance in low-endemicity settings.
Details
- Title: Subtitle
- Personalized Antibiogram: A Novel Multi-Task Machine Learning Framework for Simultaneous Prediction of Antimicrobial Resistance Profile with Enhanced Detection of Carbapenem Resistance in Enterobacteriaceae
- Creators
- Michihiko Goto - Iowa City VA Health Care SystemAnindita Bandyopadhyay - University of IowaQianyi Shi - Iowa City VA Health Care SystemYaohua Wang - University of IowaEli N Perencevich - University of IowaDavid Hernandez - Iowa City VA Health Care SystemW Nick Street - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, PMID 9203213
- DOI
- 10.1093/cid/ciag027
- PMID
- 41546531
- NLM abbreviation
- Clin Infect Dis
- ISSN
- 1537-6591
- eISSN
- 1537-6591
- Publisher
- Oxford University Press
- Grant note
- Agency for Healthcare Research and Quality (AHRQ): K08HS027472
This work was supported by the Agency for Healthcare Research and Quality (AHRQ; grant number K08HS027472 to M. G.). The funding source had no role in the design of this study and did not have any role during its collection, management, analysis, interpretation of the data, or decision to publish results.
- Language
- English
- Electronic publication date
- 01/17/2026
- Academic Unit
- Bus Admin College; Epidemiology; Nursing; Computer Science; Business Analytics; General Internal Medicine; Internal Medicine
- Record Identifier
- 9985121503302771
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