Evidence map›Paper›PMID 27030488›Full record

ArticleJournal of clinical microbiology2016

Anatomic, Geographic, and Taxon-Specific Relative Risks of Carbapenem Resistance in the Health Care System of the U.S. Department of Defense.

Emil Lesho, Uzo Chukwuma, Michael Sparks, Charlotte Neumann, Douglas Richesson, Robert Clifford, Sarah Gierhart, Paige Waterman, Mary Hinkle

Open access · hybridAbstract read
In one paragraph

Article in Journal of clinical microbiology, 2016. 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
0.9field-weighted citation impact, top 29% of its field
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, 10 citations in OpenAlex.

  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

9 authors at 4 institutions in 2 countries.

Emil LeshoAntibiotic Resistance Monitoring and Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA emil.p.lesho.mil@mail.mil.
Uzo ChukwumaAntibiotic Resistance Monitoring and Research Program, EpiData Center Department Navy and Marine Corps Public Health Center, Portsmouth, Virginia, USA.
Michael SparksAntibiotic Resistance Monitoring and Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Charlotte NeumannAntibiotic Resistance Monitoring and Research Program, EpiData Center Department Navy and Marine Corps Public Health Center, Portsmouth, Virginia, USA.
Douglas RichessonAntibiotic Resistance Monitoring and Research Program, Landstuhl Regional Medical Center, Landstuhl, Germany.
Robert CliffordAntibiotic Resistance Monitoring and Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Sarah GierhartAntibiotic Resistance Monitoring and Research Program, EpiData Center Department Navy and Marine Corps Public Health Center, Portsmouth, Virginia, USA.
Paige WatermanGlobal Emerging Infection Surveillance Section, Armed Forces Health Surveillance Branch, Silver Spring, Maryland, USA.
Mary HinkleAntibiotic Resistance Monitoring and Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Walter Reed Army Institute of Research · USNavy and Marine Corps Force Health Protection Command · USArmed Forces Health Surveillance Center · USLandstuhl Regional Medical Center · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Carbapenem-resistant Pseudomonas aeruginosa, Acinetobacter spp., and Enterobacteriaceae pose urgent public health threats. The differential burden, relative risks, associations with antimicrobial consumption, and temporal trends of those taxa in large, geographically diverse U.S. health systems remain under reported. Electronic records of all patients in a geographically dispersed 280-hospital managed-care system from 2005 to 2014 were reviewed. Carbapenem-resistant strains were identified based on Clinical and Laboratory Standards Institute guidelines and breakpoints. A total of 360,000 potentially carbapenem-resistant strains were identified from 14.7 million cultures (80% infecting and 20% surveillance). Isolation of bacteria overseas or isolation from the bloodstream was associated with a higher relative risks of carbapenem resistance (CR; P < 0.0001). Enterobacteriaceae were isolated 11 times more frequently than P. aeruginosa and Acinetobacter spp. However, compared to Enterobacteriaceae, the CR levels were 73-fold and 210-fold higher in P. aeruginosa and Acinetobacter spp., respectively. Significant differences in the relative risk of CR between taxa, anatomic, and geographic locations persisted after adjustment for other variables, the biggest differences occurring between taxa. Overall, CR rates increased for Enterobacteriaceae (P = 0.03) and decreased for Acinetobacter spp. and P. aeruginosa (P < 0.0001). These data provide a useful baseline for resistance trending and have implications for surveillance. Infections acquired overseas and bloodstream infections are particularly important areas for continued monitoring.

Indexed as

beta-Lactam ResistanceAcinetobacterAdolescentAdultAgedAged, 80 and overAnti-Bacterial AgentsCarbapenemsChildChild, PreschoolEnterobacteriaceaeFemaleGeographyGram-Negative Bacterial InfectionsHealth FacilitiesHumansAnti-Bacterial AgentsCarbapenems

Identifiers

PMID27030488
PMCPMC4879283
OpenAlexW2316081943

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.