ArticleJAC-antimicrobial resistance2021
PRO: Testing for ESBL production is necessary for ceftriaxone-non-susceptible Enterobacterales: perfect should not be the enemy of progress.
Article in JAC-antimicrobial resistance, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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.
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
12 citing papers in PubMed.
- Extended spectrum beta-lactamase and aminoglycoside modifying enzyme genes in multi drug resistant Gram-negative bacteria: A snapshot from a tertiary care centre.Medical journal, Armed Forces India · 2024Article
- Prevalence and clinical significance of the genotypic carriage among ESBL phenotype-negativeFrontiers in cellular and infection microbiology · 2024Article
- Efficacy of noncarbapenem therapy for the treatment of ceftriaxone-resistant Enterobacterales outside the urinary tract.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- #AMRrounds: a systematic educational approach for navigating bench to bedside antimicrobial resistance.JAC-antimicrobial resistance · 2023Review
- High-dose Cefepime vs Carbapenems for Bacteremia Caused by Enterobacterales With Moderate to High Risk of Clinically Significant AmpC β-lactamase Production.Open forum infectious diseases · 2023Article
- Clinical Impact of Ceftriaxone Resistance inOpen forum infectious diseases · 2022Article
- A Proposal for a Classification Guiding the Selection of Appropriate Antibiotic Therapy for Intra-Abdominal Infections.Antibiotics (Basel, Switzerland) · 2022Review
- Infectious Diseases Society of America 2022 Guidance on the Treatment of Extended-Spectrum β-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR-P. aeruginosa).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Correlation between Identification of β-Lactamase Resistance Genes and Antimicrobial Susceptibility Profiles in Gram-Negative Bacteria: a Laboratory Data Analysis.Microbiology spectrum · 2022Article
- Loads of Coliforms and Fecal Coliforms and Characterization of ThermotolerantFoods (Basel, Switzerland) · 2022Article
- Extended-spectrum β-lactamases: an update on their characteristics, epidemiology and detection.JAC-antimicrobial resistance · 2021Review
- Should ceftriaxone-resistant Enterobacterales be tested for ESBLs? A PRO/CON debate.JAC-antimicrobial resistance · 2021Review
Corrections and comments
- Commented on by
Authors and funding
2 authors.
Funding
Abstract
The MERINO trial has seemingly laid to rest the question: 'Are carbapenems the preferred therapy for ESBL-producing infections?' It has, however, brought another important question to the forefront: 'How do we know when we have an ESBL-producing infection?' A commonly used approach is the interpretation that non-susceptibility to third-generation cephalosporins (e.g. ceftriaxone MICs of ≥2 mg/L) is an accurate proxy for ESBL production. We believe that relying on antibiotic susceptibility results alone to predict ESBL production in clinical isolates is fraught with issues. Rather, we believe accurate molecular assays that detect a comprehensive range of ESBL genes, along with other relevant β-lactamase genes, are well within the reach of existing technology and necessary to optimize patient care. Herein, we elaborate on why the current approach for determining whether an organism is likely to be an ESBL producer (i) is inaccurate; (ii) encourages carbapenem overuse; (iii) ignores the potential for ESBL production in other Enterobacterales species; and (iv) promotes the silent epidemic of ESBL transmission.
Identifiers
What OpenQuestion holds
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.