Trial reportIntensive care medicine2008
Systematic surveillance cultures as a tool to predict involvement of multidrug antibiotic resistant bacteria in ventilator-associated pneumonia.
Trial report in Intensive care medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Guideline
- Strategies to reduce curative antibiotic therapy in intensive care units (adult and paediatric).Intensive care medicine · 2015Guideline
- Value of lower respiratory tract surveillance cultures to predict bacterial pathogens in ventilator-associated pneumonia: systematic review and diagnostic test accuracy meta-analysis.Intensive care medicine · 2013Pooled it
- Clinical Differences Between Survivors and Non-Survivors of Ventilator-Associated Pneumonia: The Roles of Sulbactam/Ampicillin and Methicillin-ResistantInfection and drug resistance · 2024Article
- Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action.World journal of emergency surgery : WJES · 2023Review
- Multiple-site decontamination to prevent acquired infection in patients with veno-venous ECMO support.Annals of intensive care · 2023Article
- Healthcare-associated infections in adult intensive care unit patients: Changes in epidemiology, diagnosis, prevention and contributions of new technologies.Intensive & critical care nursing · 2022Article
- Use of Antimicrobials for Bloodstream Infections in the Intensive Care Unit, a Clinically Oriented Review.Antibiotics (Basel, Switzerland) · 2022Review
- Convergence of Biofilm Formation and Antibiotic Resistance inFrontiers in medicine · 2022Review
- Impact of systematic screening for AmpC-hyperproducing Enterobacterales intestinal carriage in intensive care unit patients.Annals of intensive care · 2020Article
- Identification of respiratory microbiota markers in ventilator-associated pneumonia.Intensive care medicine · 2019Article
- Article
- Relation between presence of extended-spectrum β-lactamase-producing Enterobacteriaceae in systematic rectal swabs and respiratory tract specimens in ICU patients.Annals of intensive care · 2017Article
- Frequency, associated factors and outcome of multi-drug-resistant intensive care unit-acquired pneumonia among patients colonized with extended-spectrum β-lactamase-producing Enterobacteriaceae.Annals of intensive care · 2017Article
- Preoperative asymptomatic leukocytosis and postoperative outcome in cardiac surgery patients.PloS one · 2017Article
- Pre-emptive antibiotic therapy to reduce ventilator-associated pneumonia: "thinking outside the box".Critical care (London, England) · 2016Article
- Ventilator-Associated Pneumonia (VAP) with Multidrug-Resistant (MDR) Pathogens: Optimal Treatment?Current infectious disease reports · 2015Article
- Minimizing antibiotic exposure in the ICU: in search of the optimal strategy.Critical care (London, England) · 2014Article
- Development of antibiotic treatment algorithms based on local ecology and respiratory surveillance cultures to restrict the use of broad-spectrum antimicrobial drugs in the treatment of hospital-acquired pneumonia in the intensive care unit: a retrospective analysis.Critical care (London, England) · 2014Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess prediction of multidrug resistant (MDR) pathogens in ventilator-associated pneumonia (VAP) by systematic surveillance cultures (SC) and to assess the contribution of SC to initial antibiotic therapy.
designProspective cohort study of patients with microbiologically confirmed VAP. Comparison of actual early antibiotic coverage with three hypothetical empirical schemes.
settingA 50-bed university hospital ICU. SC consisted of oral, nasal, urinary and rectal samples upon admission, 3-weekly urinary and 1-weekly oral, nasal, and rectal samples in all patients, 3-weekly tracheal aspirates in intubated patients.
resultsMDR pathogens were found in 86 of 199 VAP episodes. Sensitivity of SC to predict MDR pathogens was 69% (tracheal SC) and 82% (all SC); specificity was 96% (tracheal) and 91% (all), respectively. Appropriate antibiotic coverage within 24 h and 48 h following MDR VAP was 77% and 89%, respectively. A carbapenem-based empirical scheme would have been equally appropriate (83% vs. 77% at 24 h; 83% vs. 89% at 48 h), but a beta-lactam-fluoroquinolone empirical therapy would have been less (59% vs. 77% at 24 h; 59% vs. 89% at 48 h) as would have been beta-lactam-aminoglycoside therapy (68% vs. 77% at 24 h; 68% vs. 89% at 48 h). Empirical comparators would have resulted in significantly more prescription of broad-spectrum antibiotics within the first 48 h.
conclusionsWith MDR pathogens highly prevalent, systematic SC predicted MDR pathogens causing VAP in 69% to 82% and may have contributed to high rates of early appropriate antibiotic therapy with limited use of broad-spectrum antimicrobials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.