Observational studyCritical care (London, England)2025
Incidence of hospital-acquired infections due to carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa in critically ill patients in Italy: a multicentre prospective cohort study.
Observational study in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed.
- Carbapenem-Sparing Antimicrobial Stewardship in Internal Medicine: A Prospective Quasi-Experimental Before-and-After Pilot Implementation Study.Antibiotics (Basel, Switzerland) · 2026Article
- Clinical outcomes and therapeutic approaches in pediatric infections caused by metallo-β-lactamase-producing organisms: a five-year experience in a tertiary care hospital.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Photoinduced Fluorescence Changes in Selected Bacterial Strains Under 405 nm Laser Excitation: An In Vitro Hue-Based Monitoring Approach.Micromachines · 2026Article
- Real-World Use of Cefiderocol for Multidrug-Resistant Gram-Negative Infections in Critically Ill ICU Patients: A Single-Center Case Series.Pathogens (Basel, Switzerland) · 2026Article
- Carbapenemase-producing Enterobacterales infections: a real-world cohort study from a secondary hospital in Shanghai, China.BMC infectious diseases · 2026Article
- In vitro activity of aztreonam/avibactam and comparators against Enterobacterales isolates from patients with hospital-acquired pneumonia, ventilator-associated pneumonia, and complicated intra-abdominal infections (ATLAS, 2021-2022).The Journal of antimicrobial chemotherapy · 2026Article
- Challenges and opportunities in the management of severe pneumonia. Key concepts from the Seventh Annual Meeting of Spanish Experts 2025.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Characterization of prophage carrying blaEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Case report: rapid in vivo resistance mechanism shifts in multiple carbapenem-resistant Pseudomonas aeruginosa strains after esophagectomy in an immunocompromised patient: a case report.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Precision Approaches to Carbapenem-Resistant Infections in the ICU: Integrating Diagnostics, Stewardship, and Novel Therapies.Diagnostics (Basel, Switzerland) · 2026Review
- The threat of multidrug-resistant microorganisms: active surveillance of key antimicrobial resistant pathogens in 2025 - a report from the INVIFAR network.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Global threats in local wards: Dissemination of high-risk clones resistant to last-generation cephalosporins and carbapenems in Iraqi hospitals.IJID regions · 2026Article
- The impact of faster antimicrobial susceptibility testing report and dual antimicrobial susceptibility testing cards on the antibiotic therapy and economics of hospitalized bloodstream infection patients.BMC microbiology · 2026Article
- Burden and resistance of Gram-negative pathogens in ICU-acquired infections in Vietnam: a cross-sectional study.Iranian journal of microbiology · 2026Article
- Microbiological characterization and clinical outcomes of carbapenem-resistant enterobacterales infections in a paediatric hospital in Mexico.BMC infectious diseases · 2026Observational
- Clinical Outcomes of Bloodstream Infections in Liver Transplant Recipients: A Ten-Year Single-Center Retrospective Analysis, from Türkiye.Antibiotics (Basel, Switzerland) · 2026Article
- Activity of aztreonam-avibactam, cefiderocol, and cefepime-taniborbactam against a global collection of genetically characterized metallo-β-lactamase-producing Enterobacterales.Antimicrobial agents and chemotherapy · 2026Article
- Metallo-β-lactamase-producingFrontiers in microbiology · 2026Review
- Carbapenem-Resistant Gram-Negative Bacteria: Mechanisms, Pathogen-Specific Strategies.Infection and drug resistance · 2026Review
- Development of a predictive model using automated machine learning for Carbapenem-resistant Organisms (CRO) infections in hospitalized patients.Frontiers in microbiology · 2026Article
Corrections and comments
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Authors and funding
28 authors.
Funding
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Abstract
backgroundCarbapenem-Resistant Gram-Negative Bacteria, including Carbapenem-Resistant Enterobacterales (CRE) and Carbapenem-Resistant Pseudomonas aeruginosa (CRPA), are common causes of infections in intensive care units (ICUs) in Italy.
objectiveThis prospective observational study evaluated the epidemiology, management, microbiological characterization, and outcomes of hospital-acquired CRE or CRPA infections treated in selected ICUs in Italy.
methodsThe study included patients with hospital-acquired infections due to CRE and CRPA treated in 20 ICUs from June 2021 to February 2023. The primary endpoint was the 1-year incidence of CRE/CRPA infections. Secondary endpoints included the rate of CRE/CRPA infections, mortality in ICU, infection outcome, and microbiological characterization.
resultsAmong 13,088 patients admitted over the 12-month study period across each of the 20 ICUs, 283 had CRE infections, and 138 had CRPA infections. The incidence of CRE and CRPA infections was 3.57 per 1000 patient days and 1.74 per 1000 patient days, respectively. The proportion of CRE and CRPA infections over the total number of infections due to Enterobacterales and Pseudomonas aeruginosa was 19.2% and 26.8%, respectively. Among 158 patients included in the full analysis, 98 (62%) had CRE infections and 60 (38%) had CRPA infections. Ventilator-associated pneumonia and bloodstream infections were the most common infections, occurring in 53.8 and 34.2% of cases. Empirical therapy targeting gram-negative pathogens resulted inappropriate in 59.2% of analysed patients (77/130). The overall crude mortality in ICU rate was 30.4%, with a higher rate in CRE patients (36.7%) than in CRPA patients (20.0%). Clinical success, including microbiological eradication, was achieved in 50.6% of cases. Klebsiella pneumoniae was observed as the predominant CRE species, and all CRE isolates, including metallo-β-lactamases-producing CRE (MBL-CRE), were susceptible to Aztreonam-Avibactam.
conclusionsThese results highlight the high prevalence of CRE/CRPA infections in Italian ICUs and emphasize the need for enhanced prevention and surveillance strategies.
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