Evidence map›Paper›PMID 36483386›Full record

ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2022

Increased carbapenemase testing following implementation of national VA guidelines for carbapenem-resistant Enterobacterales (CRE).

Margaret A Fitzpatrick, Katie J Suda, Swetha Ramanathan, Geneva Wilson, Linda Poggensee, Martin Evans, Makoto M Jones, Christopher D Pfeiffer, J Stacey Klutts, Eli Perencevich and 3 more

Abstract read
In one paragraph

Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
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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

13 authors.

Margaret A FitzpatrickDepartment of Veterans' Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois.ORCID https://orcid.org/0000-0002-1919-9238
Katie J SudaDepartment of Veterans' Affairs, Center of Health Equity Research & Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.
Swetha RamanathanDepartment of Veterans' Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois.
Geneva WilsonDepartment of Veterans' Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois.
Linda PoggenseeDepartment of Veterans' Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois.
Martin EvansDepartment of Veterans' Affairs, Lexington VA Medical Center, Lexington, Kentucky.
Makoto M JonesDepartment of Veterans' Affairs, VA Salt Lake City Healthcare System, Salt Lake City, Utah.
Christopher D PfeifferDepartment of Veterans' Affairs, Portland VA Healthcare System, Portland, Oregon.
J Stacey KluttsCenter for Access & Delivery Research and Evaluation, Department of Veterans' Affairs, Iowa City VA Health Care System, Iowa City, Iowa.
Eli PerencevichCenter for Access & Delivery Research and Evaluation, Department of Veterans' Affairs, Iowa City VA Health Care System, Iowa City, Iowa.
Michael RubinCenter for Access & Delivery Research and Evaluation, Department of Veterans' Affairs, Iowa City VA Health Care System, Iowa City, Iowa.
Charlesnika T EvansDepartment of Veterans' Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois.
QUERI CARRIAGE Program

Funding

HSRD VA IK6 HX003156HSRD VA IP1 HX001993
6 · The paper itself

Abstract

Objective: To describe national trends in testing and detection of carbapenemases produced by carbapenem-resistant Enterobacterales (CRE) and associate testing with culture and facility characteristics. Design: Retrospective cohort study. Setting: Department of Veterans' Affairs medical centers (VAMCs). Participants: Patients seen at VAMCs between 2013 and 2018 with cultures positive for CRE, defined by national VA guidelines. Interventions: Microbiology and clinical data were extracted from national VA data sets. Carbapenemase testing was summarized using descriptive statistics. Characteristics associated with carbapenemase testing were assessed with bivariate analyses. Results: Of 5,778 standard cultures that grew CRE, 1,905 (33.0%) had evidence of molecular or phenotypic carbapenemase testing and 1,603 (84.1%) of these had carbapenemases detected. Among these cultures confirmed as carbapenemase-producing CRE, 1,053 (65.7%) had molecular testing for ≥1 gene. Almost all testing included KPC (n = 1,047, 99.4%), with KPC detected in 914 of 1,047 (87.3%) cultures. Testing and detection of other enzymes was less frequent. Carbapenemase testing increased over the study period from 23.5% of CRE cultures in 2013 to 58.9% in 2018. The South US Census region (38.6%) and the Northeast (37.2%) region had the highest proportion of CRE cultures with carbapenemase testing. High complexity (vs low) and urban (vs rural) facilities were significantly associated with carbapenemase testing ( Conclusions: Between 2013 and 2018, carbapenemase testing and detection increased in the VA, largely reflecting increased testing and detection of KPC. Surveillance of other carbapenemases is important due to global spread and increasing antibiotic resistance. Efforts supporting the expansion of carbapenemase testing to low-complexity, rural healthcare facilities and standardization of reporting of carbapenemase testing are needed.

Identifiers

PMID36483386
PMCPMC9726513

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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.