ArticleIntensive care medicine2023
Relationship between immunosuppression and intensive care unit-acquired colonization and infection related to multidrug-resistant bacteria: a prospective multicenter cohort study.
Article in Intensive care medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- Impact of a strategy using multiplex PCR on targeted antibiotic therapy for patients with suspected ventilator-associated pneumonia or hospital-acquired pneumonia requiring mechanical ventilation: a randomized, single-blind trial.Intensive care medicine · 2026Article
- ICU-acquired infection in neutropenic patients.Critical care (London, England) · 2026Article
- Development and validation of a nomogram for predicting progression from multidrug-resistant bacterial colonization to infection in lymphoma patients.Discover oncology · 2026Article
- Bacterial co-detection is associated with higher multidrug-resistantJAC-antimicrobial resistance · 2026Article
- Early de-escalation of antifungal treatment in critically ill immunocompromised patients with proven or probable invasive candidiasis: A retrospective multicentre study.Annals of intensive care · 2026Article
- Immune imbalance markers: key factors in early recognition of multidrug-resistant bacterial infections in non-immunocompromised VAP patients.Frontiers in immunology · 2026Article
- Clinical Characteristics and Outcomes of Carbapenem-Resistant Gram-Negative Bacteria Pneumonia in Immunocompromised ICU Patients: A Retrospective Study.Infection and drug resistance · 2026Article
- Infectious Complications and Prognostic Factors of Mortality in Patients with Lupus Nephritis Admitted to Intensive Care Units.Journal of clinical medicine · 2025Article
- Determinants of empiric combination antibiotic therapy for hospital associated bloodstream infections in the intensive care unit.Scientific reports · 2025Article
- On the tightrope between life and graft: immunosuppression in critically ill solid organ transplant recipients.Intensive care medicine · 2025Article
- Advocating for the recognition of underlying immunosuppression in critical illness.EClinicalMedicine · 2025Review
- Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical Center.Infection and drug resistance · 2025Article
- Prognostic value of the lactate-to-albumin ratio in critically ill chronic heart failure patients with sepsis: insights from a retrospective cohort study.Frontiers in medicine · 2025Article
- The incidences and outcomes of acquiring multidrug-resistant Enterobacterales and enterococci colonization among hospitalized hematologic malignancy patients.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Risk Factors and Molecular Epidemiology of Infections Among Patients with Intestinal Colonization by Carbapenem-ResistantInfection and drug resistance · 2025Article
- Septic shock in the immunocompromised cancer patient: a narrative review.Critical care (London, England) · 2024Review
- Immunosuppression at ICU admission is not associated with a higher incidence of ICU-acquired bacterial bloodstream infections: the COCONUT study.Annals of intensive care · 2024Article
- Impact of Immunosuppressed Status on Prognosis of Carbapenem-Resistant Organisms Bloodstream Infections.Infectious diseases and therapy · 2024Article
- Challenges for a broad international implementation of the current severe community-acquired pneumonia guidelines.Intensive care medicine · 2024Review
- Incidence of Carbapenem-Resistant Gram-Negative Bacterial Infections in Critically Ill Patients with COVID-19 as Compared to Non-COVID-19 Patients: A Prospective Case-Control Study.Critical care research and practice · 2024Article
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15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe impact of immunosuppression on intensive care unit (ICU)-acquired colonization and infection related to multidrug-resistant (MDR) bacteria (ICU-MDR-col and ICU-MDR-inf, respectively) is unknown.
methodsWe carried out an observational prospective cohort study in 8 ICUs in France (all with single-bed rooms and similar organizational characteristics). All consecutive patients with an ICU stay > 48 h were included, regardless of immune status, and followed for 28 days. Patients underwent systematic screening for colonization with MDR bacteria upon admission and every week subsequently. Immunosuppression was defined as active cancer or hematologic malignancy, neutropenia, solid-organ transplant, use of steroids or immunosuppressive drugs, human immunodeficiency virus infection and genetic. The primary endpoint was the incidence rate of a composite outcome including ICU-MDR-col and/or ICU-MDR-inf.
results750 patients (65.9% males, median age 65 years) were included, among whom 264 (35.2%) were immunocompromised. Reasons for ICU admission, severity scores and exposure to invasive devices and antibiotics during ICU stay were comparable between groups. After adjustment for center and pre-specified baseline confounders, immunocompromised patients had a lower incidence rate of ICU-MDR-col and/or ICU-MDR-inf (adjusted incidence ratio 0.68, 95% CI 0.52-0.91). When considered separately, the difference was significant for ICU-MDR-col, but not for ICU-MDR-inf. The distribution of MDR bacteria was comparable between groups, with a majority of Enterobacteriacae resistant to third-generation cephalosporins (~ 74%).
conclusionImmunocompromised patients had a significantly lower incidence rate of a composite outcome including ICU-MDR-col and/or ICU-MDR-inf. This finding points to the role of contact precautions and isolation measures, and could have important implications on antibiotic stewardship in this population.
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