Evidence map›Paper›PMID 23221191›Full record

ReviewInfection control and hospital epidemiology2013

Defining relatedness in studies of transmission of antimicrobial-resistant organisms: variability in definitions across studies and impact of different approaches on study conclusions.

Rachel M Greenblatt, Jennifer H Han, Irving Nachamkin, Pam Tolomeo, Ebbing Lautenbach

Abstract readComparative StudyReview
In one paragraph

Review in Infection control and hospital epidemiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Rachel M GreenblattUniversity of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Jennifer H Han
Irving Nachamkin
Pam Tolomeo
Ebbing Lautenbach

Funding

Clinical Impact of Quinolone-Resistant E.coli carriageR01AI055008 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI LAUTENBACH, EBBING · 2004 to 2007
$2.6M
Mentoring and patient-oriented research in antimicrobial resistanceK24AI080942 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI LAUTENBACH, EBBING · 2009 to 2013
$853k
ACL HHS U54CK000163NCEZID CDC HHS U54-CK000163NIAID NIH HHS K24 AI080942NIAID NIH HHS K24-AI080942NIAID NIH HHS R01 AI055008NIAID NIH HHS R01-AI055008
6 · The paper itself

Abstract

objectiveComparison of studies evaluating patient-to-patient transmission of organisms is difficult, given the lack of standardized criteria. We used fluoroquinolone-resistant Escherichia coli (FQREC) as a model to characterize variability in definitions of relatedness across studies and to evaluate the resultant impact on study conclusions.

designNarrative review and cohort study.

methodsThe narrative review compared relatedness criteria across studies of FQREC. Additionally, an existing database was used to compare relatedness of isolates on the basis of molecular criteria alone versus molecular plus clinical criteria with different temporal cutoffs (hospitalization overlap of ≥1 day or allowance for nonoverlap of hospitalization dates of ≤7 days or ≤30 days).

resultsForty-six articles met narrative review inclusion criteria. Sixteen studies exclusively utilized molecular criteria to define relatedness. Thirty studies included molecular and clinical criteria. Of these, 6 included temporal data (ie, time period of isolate identification), 10 included patient location, and 14 included proximity and temporal criteria. For the database analysis, 353 patients were colonized with FQREC. There were 2 main clusters containing 48 and 17 related isolates within 49 pulsed-field gel electrophoresis types. Among the clusters, 18.4% of isolates were related by molecular criteria. Incorporating clinical criteria, fewer isolates were considered related: 5.7% of isolates using 30-day criteria, 3.1% using 7-day criteria, and 1.4% using 1-day overlap.

conclusionsThere is considerable variability in definitions of relatedness of FQREC. Utilizing molecular criteria alone to define relatedness overestimates transmission compared with definitions including clinical criteria. Standard definitions of relatedness in studies of antimicrobial-resistant organisms are needed.

Indexed as

Drug Resistance, MicrobialEpidemiological MonitoringFluoroquinolonesCohort StudiesCross InfectionEscherichia coliEscherichia coli InfectionsHumansMolecular TypingReference StandardsTerminology as TopicFluoroquinolones

Identifiers

PMID23221191
PMCPMC3983273

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Registered trials

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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.