ArticleAnnals of intensive care2017
Relation between presence of extended-spectrum β-lactamase-producing Enterobacteriaceae in systematic rectal swabs and respiratory tract specimens in ICU patients.
Article in Annals of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Is systematic fecal carriage screening of extended-spectrum beta-lactamase-producing Enterobacteriaceae still useful in intensive care unit: a systematic review.Critical care (London, England) · 2019Pooled it
- Ventilator-associated lower respiratory tract infections and bacteremia in medical and surgical critical care patients colonized by multidrug-resistant bacteria.BMC infectious diseases · 2025Observational
- Relative faecal abundance to predict extended-spectrum β-lactamase-producing Enterobacterales related ventilator‑associated pneumonia.Annals of intensive care · 2025Article
- Article
- Antibiotic stewardship in the ICU: time to shift into overdrive.Annals of intensive care · 2023Review
- Colonization of extended-spectrum β-lactamase-producing Enterobacteriaceae does not affect subsequent infection and liver transplant outcomes: a retrospective observational cohort study.Frontiers in public health · 2023Observational
- Pharmacokinetics, efficacy and tolerance of cefoxitin in the treatment of cefoxitin-susceptible extended-spectrum beta-lactamase producing Enterobacterales infections in critically ill patients: a retrospective single-center study.Annals of intensive care · 2022Article
- Impact of systematic screening for AmpC-hyperproducing Enterobacterales intestinal carriage in intensive care unit patients.Annals of intensive care · 2020Article
- New cephalosporins for the treatment of pneumonia in internal medicine wards.Journal of thoracic disease · 2020Review
- Semi-quantitative cultures of throat and rectal swabs are efficient tests to predict ESBL-Enterobacterales ventilator-associated pneumonia in mechanically ventilated ESBL carriers.Intensive care medicine · 2020Article
- Multidrug-resistant bacterial carriage and related healthcare-associated infections in a pediatric intensive care unit: a 6-year prospective study.Intensive care medicine · 2019Article
- Extended spectrum beta-lactamase producingAntimicrobial resistance and infection control · 2019Article
- Derivation and validation of a simple score to predict the presence of bacteria requiring carbapenem treatment in ICU-acquired bloodstream infection and pneumonia: CarbaSCORE.Antimicrobial resistance and infection control · 2019Article
- Ventilator-associated pneumonia related to ESBL-producing gram negative bacilli.Annals of translational medicine · 2018Review
- Infection-related ventilator-associated complications in ICU patients colonised with extended-spectrum β-lactamase-producing Enterobacteriaceae.Intensive care medicine · 2018Article
- Epidemiology of extended-spectrum beta-lactamase-producing Enterobacteriaceae in an intensive care unit with no single rooms.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
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe choice of empirical antimicrobial therapy for pneumonia in intensive care unit (ICU) is a challenge, since pneumonia is often related to multidrug-resistant pathogens, particularly extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). To prevent the overuse of broad-spectrum antimicrobial therapy, the main objective of this study was to test the performance of digestive colonization surveillance as a predictor of ESBL-E presence or absence in respiratory samples performed in ICU and to evaluate the impact of time sampling (≤5 days or >5 days) on such prediction.
designMulticentric retrospective observational study, including every patient with a respiratory tract specimen positive culture and a previous rectal ESBL-E screening performed within 7 days before the respiratory sample, between January 2012 and December 2014. Results were analyzed in two groups: respiratory samples obtained during the first 5 days of ICU stay (early group) and respiratory samples obtained after 5 days (late group).
interventionsnone.
resultsAmong 2498 respiratory tract samples analyzed corresponding to 1503 patients, 1557 (62.3%) were performed early (≤5 days) and 941 (37.7%) later (>5 days). Positivity rates for ESBL-E were 15.0 and 36.8% for rectal swabs in the early and late groups, respectively. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and likelihood ratios were calculated for ESBL-E digestive colonization as a predictor of ESBL-E presence in respiratory samples. PPVs of ESBL-E digestive colonization were 14.5% (95% CI [12.8; 16.3]) and 34.4% (95% CI [31.4; 37.4]), for the early and late groups, respectively, whereas NPVs were 99.2% (95% CI [98.7; 99.6]) and 93.4% (95% CI [91.9; 95.0]), respectively.
conclusionsSystematic surveillance of ESBL-E digestive colonization may be useful to limit the use of carbapenems when pneumonia is suspected in ICU. When rectal swabs are negative, the risk of having ESBL-E in respiratory samples is very low even after 5 days of ICU stay.
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