Relation between presence of extended-spectrum β-lactamase-producing Enterobacteriaceae in systematic rectal swabs and respiratory tract specimens in ICU patients

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• 作者：Hélène Carbonne ; Matthieu Le Dorze ; Anne-Sophie Bourrel…
• 关键词：Enterobacteriaceae ; Extended ; spectrum β ; lactamase ; Multidrug resistance ; Digestive colonization ; Respiratory sample ; Intensive care unit
• 刊名：Annals of Intensive Care
• 出版年：2017
• 出版时间：December 2017
• 年：2017
• 卷：7
• 期：1
• 全文大小：1137KB
• 刊物主题：Intensive / Critical Care Medicine; Emergency Medicine; Anesthesiology;
• 出版者：Springer Paris
• ISSN：2110-5820
• 卷排序：7

文摘

BackgroundThe choice of empirical antimicrobial therapy for pneumonia in intensive care unit (ICU) is a challenge, since pneumonia is often related to multidrug-resistant pathogens, particularly extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). To prevent the overuse of broad-spectrum antimicrobial therapy, the main objective of this study was to test the performance of digestive colonization surveillance as a predictor of ESBL-E presence or absence in respiratory samples performed in ICU and to evaluate the impact of time sampling (≤5 days or >5 days) on such prediction. Design: Multicentric retrospective observational study, including every patient with a respiratory tract specimen positive culture and a previous rectal ESBL-E screening performed within 7 days before the respiratory sample, between January 2012 and December 2014. Results were analyzed in two groups: respiratory samples obtained during the first 5 days of ICU stay (early group) and respiratory samples obtained after 5 days (late group). Interventions: none.