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ORIGINAL RESEARCH article

Front. Med.

Sec. Intensive Care Medicine and Anesthesiology

Construction and Validation of a Risk Assessment Scale for Multidrug-Resistant Bacteria Infections in Critically Ill Patients

Provisionally accepted
Jia  ZhaoJia Zhao1Li  YuanLi Yuan2Yujing  WangYujing Wang3Bing  LiuBing Liu2Xiaoyan  WangXiaoyan Wang2Xuexian  MaXuexian Ma2Ping  LiPing Li2,4*
  • 1School of Nursing, Xinjiang Medical University, Urumqi, China
  • 2Xinjiang Medical University Affiliated Second Hospital, Urumqi, China
  • 3Xinjiang Medical University School of Nursing, Urumqi, China
  • 4Xinjiang Population Disease and Healthcare Research Center, Urumqi, China

The final, formatted version of the article will be published soon.

Background: To develop a risk assessment scale for infections caused by multidrug-resistant organisms (MDROs) in patients with critical illness and to evaluate its reliability and validity. Methods: An initial risk assessment scale for MDRO infections in patients with critical illness was developed by using a systematic literature review, the Delphi method, and the analytic hierarchy process. Data from 750 critically ill patients admitted to the intensive care unit (ICU) of a Grade A tertiary hospital in China between January 2019 and June 2025 were analyzed. The scale's reliability and validity were assessed through exploratory factor analysis (n = 450) and confirmatory factor analysis (n = 300). Results: The risk assessment scale for MDRO infection in patients with critical illness comprised five dimensions and 20 items. The Cronbach's alpha for the total scale was 0.873. The scale-level content validity index was 0.925, with the content validity indices for individual scale items ranging 0.875–1.000. Exploratory factor analysis enabled the extraction of five common factors, which accounted for 67.861% of the cumulative variance. Confirmatory factor analysis yielded χ²/DF = 1.912, RMSEA = 0.055, CFI = 0.945, TLI = 0.935, and GFI = 0.906. The predictive efficacy of the scale for MDRO infections was validated via ROC curve analysis, yielding an area under the curve (AUC) of 0.788, sensitivity of 0.741, and specificity of 0.707, indicating a robust overall discriminative capability. Conclusions: The risk assessment scale for MDRO infection in patients with critical illness demonstrated good reliability and validity, enabling the scientific and reliable assessment of patient infection risk.

Keywords: Multi-drug resistant bacteria1, Delphi method2, scale3, Reliability4, Validity5

Received: 25 Sep 2025; Accepted: 30 Oct 2025.

Copyright: © 2025 Zhao, Yuan, Wang, Liu, Wang, Ma and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ping Li, 894088343@qq.com

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