ArticleIntensive care medicine2018
Infection-related ventilator-associated complications in ICU patients colonised with extended-spectrum β-lactamase-producing Enterobacteriaceae.
Article in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers, 1 of them a synthesis that pooled it.
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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
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 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
- Ten-Year Evaluation of Ventilator-Associated Pneumonia (VAP) According to Initial Empiric Treatment: A Retrospective Analysis Using Real-World Data.Biomedicines · 2025Article
- Retrospective ANalysis of multi-drug resistant Gram-nEgative bacteRia on veno-venous extracorporeal membrane oxygenation. The multicenter RANGER STUDY.Critical care (London, England) · 2024Article
- Performance and impact of rapid multiplex PCR on diagnosis and treatment of ventilated hospital-acquired pneumonia in patients with extended-spectrum β-lactamase-producing Enterobacterales rectal carriage.Annals of intensive care · 2024Article
- Ventilator-associated pneumonia related to extended-spectrum beta-lactamase producing Enterobacterales during severe acute respiratory syndrome coronavirus 2 infection: risk factors and prognosis.Critical care (London, England) · 2024Article
- Article
- Antibiotic stewardship in the ICU: time to shift into overdrive.Annals of intensive care · 2023Review
- Associations of the skin, oral and gut microbiome with aging, frailty and infection risk reservoirs in older adults.Nature aging · 2022Article
- Potential of Multiplex Polymerase Chain Reaction Performed on Protected Telescope Catheter Samples for Early Adaptation of Antimicrobial Therapy in ARDS Patients.Journal of clinical medicine · 2022Article
- Empiric Treatment in HAP/VAP: "Don't You Want to Take a Leap of Faith?"Antibiotics (Basel, Switzerland) · 2022Review
- Carbapenem-ResistantInfection and drug resistance · 2022Article
- Clinical Characteristics and Risk Factors for Pulmonary Infection in Emergency ICU Patients.Disease markers · 2022Article
- Timing of antibiotic therapy in the ICU.Critical care (London, England) · 2021Review
- 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
- Ventilator-associated pneumonia in adults: a narrative review.Intensive care medicine · 2020Review
- Incidence and risk factors for acquired colonization and infection due to extended-spectrum beta-lactamase-producing Gram-negative bacilli: a retrospective analysis in three ICUs with low multidrug resistance rate.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Observational
- Gastrointestinal colonization with multidrug-resistant Gram-negative bacteria during extracorporeal membrane oxygenation: effect on the risk of subsequent infections and impact on patient outcome.Annals of intensive care · 2019Article
- Focus on infection.Intensive care medicine · 2019Article
Corrections and comments
- Erratum issued
Authors and funding
19 authors at 14 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo investigate the clinical significance of infection-related ventilator-associated complications (IVAC) and their impact on carbapenem consumption in mechanically ventilated (MV) patients colonised with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLE).
methodsInception cohort study from the French prospective multicenter OUTCOMEREA database (17 ICUs, 1997-2015) including all ESBLE carriers (systematic rectal swabbing at admission then weekly and/or urinary or superficial surgical site colonisation) with MV duration > 48 h and ≥ 1 episode of IVAC after carriage documentation. All ICU-acquired infections were microbiologically documented.
resultsThe 318 enrolled ESBLE carriers (median age 68 years; males 67%; medical admission 68%; imported carriage 53%) experienced a total of 576 IVAC comprising 361 episodes (63%) without documented infection, 124 (21%) related to infections other than ventilator-associated pneumonia (VAP), 73 (13%) related to non-ESBLE VAP and 18 (3%) related to ESBLE VAP. Overall, ESBLE infections accounted for only 43 episodes (7%). Carbapenem exposure within the preceding 3 days was the sole independent predictor of ESBLE infection as the causative event of IVAC, with a protective effect (adjusted odds ratio 0.2, 95% confidence interval 0.05-0.6; P < 0.01). Carbapenems were initiated in 9% of IVAC without infection, 15% of IVAC related to non-VAP infections, 42% of IVAC related to non-ESBLE VAP, and 56% of IVAC related to ESBLE VAP (ESBLE VAP versus non-ESBLE VAP: P = 0.43).
conclusionsIVAC in ESBLE carriers mostly reflect noninfectious events but act as a strong driver of empirical carbapenem consumption. ESBLE infections are scarce yet hard to predict, strengthening the need for novel diagnostic approaches and carbapenem-sparing alternatives.
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