Jingchao Shi ¹ Xiaoting Mao ^1,2 Jianghao Cheng ³ Lijia Shao ¹ Xiaoyun Shan ¹ Yijun Zhu ^1*

• ¹ Jinhua Central Hospital, Jinhua, China
• ² Jinhua Maternity and Child Health Care Hospital, Jinhua, Zhejiang Province, China
• ³ Zhejiang Cancer Hospital, University of Chinese Academy of Sciences, Hangzhou, Zhejiang, China

Background: Extensively drug-resistant Acinetobacter baumannii (XDRAB) has become a significant pathogen in hospital environments, particularly in intensive care units (ICUs). XDRAB's resistance to conventional antimicrobial treatments and ability to survive on various surfaces pose a substantial threat to patient health, often resulting in severe infections such as ventilator-associated pneumonia (VAP) and bloodstream infections (BSI).We retrospectively analyzed clinical data from 559 patients with XDRAB infections admitted to Jinhua Central Hospital between January 2021 and December 2023. Patients were randomly divided into a training set (391 cases) and a testing set (168 cases). Variables were selected using Lasso regression and logistic regression analysis, and a predictive model was constructed and validated internally and externally. Model performance and clinical utility were evaluated using the Hosmer-Lemeshow test, C-index, ROC curve, decision curve analysis (DCA), and clinical impact curve (CIC).Results: Lasso regression analysis was used to screen 35 variables, selecting features through 10fold cross-validation. We chose lambda.1se=0.03450 (log(lambda.1se)=-3.367), including 10 nonzero coefficient features. These features were then included in a multivariate logistic regression analysis, identifying 8 independent risk factors for XDRAB infection: ICU stay of 1-7 days (OR=3.