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ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2023

Carriage of multidrug-resistant Gram-negative bacilli: duration and risk factors.

S Herrera, B Torralbo, S Herranz, J Bernal-Maurandi, E Rubio, C Pitart, I Fortes, S Valls, L Rodríguez, G Santana and 11 more

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Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing 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

7 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Article
  5. Article
  6. Extensively Drug-Resistant Pseudomonas aeruginosa Outbreak Associated With Artificial Tears.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024
    Article
  7. Article
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

21 authors.

S HerreraDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.ORCID http://orcid.org/0000-0002-5057-354X
B TorralboPreventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain.
S HerranzPreventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain.
J Bernal-MaurandiDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
E RubioDepartment of Microbiology, Hospital Clinic, University of Barcelona, ISGLOBAL, Barcelona, Spain.
C PitartDepartment of Microbiology, Hospital Clinic, University of Barcelona, ISGLOBAL, Barcelona, Spain.
I FortesPreventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain.
S VallsPreventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain.
L RodríguezPreventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain.
G SantanaPreventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain.
M BodroDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
C Garcia-VidalDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
M Hernández-MenesesDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
P PuertaDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
L MorataDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
A VillellaPreventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain.
M J BertranPreventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain.
M BreyDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
A SorianoDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
A Del RíoDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
J A MartinezDepartment of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain. jamarti@clinic.cat.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Identification of risk factors influencing the duration of carriage of multidrug-resistant Gram-negative bacilli (MDR-GNB) may be useful for infection control. The aim of this study is to estimate the impact of several factors collected for routine hospital surveillance on the duration of carriage of selected MDR-GNB. From January 2015 to July 2021, patients with at least two clinical/surveillance samples positive for MDR-GNB different from ESBL-producing E. coli or AmpC - exclusively producing Enterobacterales were assessed. Microorganisms, age, number of admissions, clinical or rectal sample, sex, and admission service were evaluated as risk factors. Multivariate analysis was performed by a Cox proportional hazard model. A total of 1981 episodes of colonization were included. Involved microorganisms were ESBL-Klebsiella pneumoniae (KP) in 1057 cases (53.4%), other ESBL-non-E. coli Enterobacterales in 91 (4.6%), OXA-48-KP in 263 (13.3%), KPC-KP in 90 (4.5%), VIM-KP in 29 (1.5%), carbapenemase-producing non-KP Enterobacterales (CP-non-KP) in 124 (6.3%), and MDR Pseudomonas aeruginosa (MDR-PAER) in 327 (16.5%). No differences in duration of colonization were observed among ESBL-KP (median colonization time 320 days), ESBL-non-E. coli Enterobacterales (226 days), OXA48-KP (305 days), and MDR-PAER (321 days). For each group, duration of colonization was significantly longer than that of KPC-KP (median colonization time 60 days), VIM-KP (138 days), and CP-non-KP (71 days). Male sex (HR = 0.88; 95% CI 0.78-0.99), detection in Hepatology-Gastroenterology (HR = 0.71; 95% CI 0.54-0.93), clinical sample (HR = 0.61; 95% CI 0.53-0.69), and > 2 admissions after first detection (HR = 0.47; 95% CI 0.42-0.52) were independent predictors of longer carriage, whereas VIM-KP (HR = 1.61; 95% CI 1.04-2.48), KPC-KP (HR = 1.85; 95% CI 1.49-2.3), and CP-non-KP (HR = 1.92; 95% CI 1.49-2.47) were associated with shorter colonization time. Duration of colonization was significantly longer for ESBL-KP, other ESBL-non-E. coli Enterobacterales, OXA-48-KP, and MDR-PAER. For these microorganisms, prolonging surveillance up to 2.5-3 years should be considered. Male sex, clinical sample, multiple readmissions, admission service, and type of microorganism are independent predictors of the duration of carriage.

Indexed as

beta-LactamasesGram-Negative BacteriaAnti-Bacterial AgentsDrug Resistance, Multiple, BacterialEscherichia coliGastrointestinal TractHospitalizationHumansKlebsiella pneumoniaeMaleRisk FactorsAnti-Bacterial Agentsbeta-LactamasesCarriageESBLKPCMDROXA48Pseudomonas aeruginosa

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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.