ReviewJAC-antimicrobial resistance2021
Adverse clinical outcomes associated with infections by Enterobacterales producing ESBL (ESBL-E): a systematic review and meta-analysis.
Review 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 40 papers, 2 of them syntheses that pooled 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.
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
40 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence of Enterobacterales Producing Extended-Spectrum Beta-Lactamases According to One Health Approach in Burkina Faso: A Systematic Review with Meta-Analysis.Journal of epidemiology and global health · 2026Pooled it
- Extended-spectrum β-lactamase production and antimicrobial resistance among Enterobacteriaceae causing clinical infections in Africa: a systematic review and meta-analysis (2012-2020).European journal of medical research · 2025Pooled it
- Risk-Stratified Effectiveness of Cephamycins Versus Carbapenems for ESBL-ProducingAntibiotics (Basel, Switzerland) · 2026Review
- Article
- Free-ranging hedgehogs as sentinels of environmental extended-spectrum β-lactamase-producing Enterobacterales.One health (Amsterdam, Netherlands) · 2026Article
- Mortality risk of ESBL producers in Escherichia coli bacteraemia: a comprehensive analysis using the PROBAC cohort.The Journal of antimicrobial chemotherapy · 2026Article
- Uropathogens and prognosis among patients with hospital-diagnosed acute pyelonephritis: insights from a 19-year population-based cohort study.Infection · 2026Article
- Retrospective study on antibiotic resistance profiles of uropathogenicFrontiers in microbiology · 2026Article
- Bacterial spectrum and proportion of multidrug-resistant bacteria in clinical samples from a regional hospital in Lambaréné, Gabon (2017-2023): Implications for antimicrobial resistance surveillance and public health.PLOS global public health · 2026Article
- Surveillance of CTX-M group 1-producingFrontiers in microbiology · 2026Article
- Epidemiology and risk factors ofEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Effect of Mutations on the Evolution of Extended Spectrum β-lactamases (ESBL).The protein journal · 2025Review
- A 46-week outbreak of ertapenem-resistant, non-carbapenemase encodingEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Risk Factors and Clinical Impact of Extended-Spectrum Beta-Lactamase (ESBL)-ProducingAntibiotics (Basel, Switzerland) · 2025Article
- Antibiotic Therapy Duration for Multidrug-Resistant Gram-Negative Bacterial Infections: An Evidence-Based Review.International journal of molecular sciences · 2025Review
- Infection Risk Associated With Colonization by Multidrug-Resistant Gram-Negative Bacteria: An Umbrella Review and Meta-analysis.Open forum infectious diseases · 2025Article
- Infection prevention and control without borders: comparison of guidelines on multidrug-resistant organisms in the northern Dutch-German cross-border region.Antimicrobial resistance and infection control · 2025Article
- Global prevalence of human intestinal carriage of ESBL-producingJAC-antimicrobial resistance · 2025Review
- Evaluation of extended-spectrumFrontiers in microbiology · 2025Article
- The gut microbiome as a major source of drug-resistant infections: emerging strategies to decolonize and target the gut reservoir.Frontiers in cellular and infection microbiology · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEnterobacterales producing ESBL (ESBL-E) have been notable for their rapid expansion in community settings. This systematic review and meta-analysis aimed to summarize evidence investigating the association between ESBL-E infection and adverse clinical outcomes, defined as bacteraemia, sepsis or septic shock, and all-cause mortality in adult patients.
methodsDatabase search was conducted in PubMed, Scopus and EMBASE. In general, studies were screened for effect estimates of ESBL-E colonization or infection on clinical outcomes with non-ESBL-producing Enterobacterales as comparator, adult populations and molecular ascertainment of ESBL gene. Meta-analysis was performed using the inverse variance heterogeneity model.
resultsEighteen studies were identified, including 1399 ESBL-E and 3200 non-ESBL-E infected patients. Sixteen of these studies included only bacteraemic patients. Mortality was studied in 17 studies and ESBL-E infection was significantly associated with higher odds of mortality compared with non-ESBL-producing Enterobacterales infection (OR = 1.70, 95% CI: 1.15-2.49,
conclusionsInfections by ESBL-E appear to be significantly associated with mortality but not septic shock. Available studies investigating bacteraemia and shock as an intermediate outcome of ESBL-E infections are lacking. Future studies investigating the relationship between clinical outcomes and molecular characteristics of resistant strains are further warranted, along with studies investigating this in non-bacteraemic patients.
Identifiers
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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.