PMID- 35008044
OWN - NLM
STAT- MEDLINE
DCOM- 20220308
LR  - 20220308
IS  - 1476-1645 (Electronic)
IS  - 0002-9637 (Print)
IS  - 0002-9637 (Linking)
VI  - 106
IP  - 2
DP  - 2022 Jan 10
TI  - Prior Carriage Predicts Intensive Care Unit Infections Caused by 
      Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae.
PG  - 525-531
LID - tpmd201436 [pii]
LID - 10.4269/ajtmh.20-1436 [doi]
AB  - Intensive care unit-acquired infection (ICU-AI) and extended-spectrum 
      beta-lactamase-producing Enterobacteriaceae (ESBL-PE) carriage are a major 
      concern worldwide. Our objective was to investigate the impact of ESBL-PE 
      carriage on ICU-AI. Our study was prospective, observational, and 
      noninterventional. It was conducted over a 5-year period (Jan 2013-Dec 2017) in 
      the medical-surgical intensive care unit of the Cayenne General Hospital (French 
      Amazonia). During the study period, 1,340 patients were included, 271 (20.2%) 
      developed ICU-AI, and 16.2% of these were caused by ESBL-PE. The main sites of 
      ICU-AI were ventilator-associated pneumonia (35.8%) and primary bloodstream 
      infection (29.8%). The main responsible microorganisms were Staphylococcus 
      aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae (ESBL-P in 35.8% of 
      isolates), and Enterobacter cloacae (ESBL-P in 29.8% of isolates). Prior ESBL-PE 
      carriage was diagnosed in 27.6% of patients with ICU-AI. In multivariable 
      analysis, the sole factor associated with ESBL-PE as the responsible organism of 
      ICU-AI was ESBL-PE carriage before ICU-AI (P < 0.001; odds ratio: 7.9 95% CI: 
      3.4-18.9). ESBL-PE carriers (74 patients) developed ICU-AI which was caused by 
      ESBL-PE in 32 cases (43.2%). This proportion of patients carrying ESBL-PE who 
      developed ICU-AI to the same microorganism was 51.2% in ESBL-P K. pneumoniae, 
      5.6% in ESBL-P Escherichia coli, and 40% in ESBL-P Enterobacter spp. NPV of 
      ESBL-PE carriage to predict ICU-AI caused by ESBL-PE was above 94% and PPV was 
      above 43%. Carriage of ESBL-P K pneumoniae and Enterobacter spp. is a strong 
      predictor of ICU-AI caused by these two microorganisms.
FAU - Kallel, Hatem
AU  - Kallel H
AD  - Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana.
AD  - Tropical Biome and Immunophysiopathology (TBIP), Universite de Guyane, Cayenne, 
      French Guiana.
AD  - Univ. de Lille, CNRS, Inserm, Institut Pasteur de Lille, Lille, France.
FAU - Houcke, Stephanie
AU  - Houcke S
AD  - Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana.
FAU - Resiere, Dabor
AU  - Resiere D
AD  - Intensive Care Unit, Martinique University Hospital, Fort de France, Martinique.
FAU - Court, Thibault
AU  - Court T
AD  - Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana.
FAU - Roncin, Cesar
AU  - Roncin C
AD  - Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana.
FAU - Raad, Mathieu
AU  - Raad M
AD  - Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana.
FAU - Nkontcho, Flaubert
AU  - Nkontcho F
AD  - Pharmacy Department, Cayenne General Hospital, Cayenne, French Guiana.
FAU - Demar, Magalie
AU  - Demar M
AD  - Tropical Biome and Immunophysiopathology (TBIP), Universite de Guyane, Cayenne, 
      French Guiana.
AD  - Univ. de Lille, CNRS, Inserm, Institut Pasteur de Lille, Lille, France.
AD  - Laboratory of Microbiology, Cayenne General Hospital, Cayenne, French Guiana.
FAU - Pujo, Jean
AU  - Pujo J
AD  - Emergency Department, Cayenne General Hospital, Cayenne, French Guiana.
FAU - Hommel, Didier
AU  - Hommel D
AD  - Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana.
FAU - Djossou, Felix
AU  - Djossou F
AD  - Tropical Biome and Immunophysiopathology (TBIP), Universite de Guyane, Cayenne, 
      French Guiana.
AD  - Univ. de Lille, CNRS, Inserm, Institut Pasteur de Lille, Lille, France.
AD  - Tropical and Infectious Diseases Department, Cayenne General Hospital, Cayenne, 
      French Guiana.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20220110
PL  - United States
TA  - Am J Trop Med Hyg
JT  - The American journal of tropical medicine and hygiene
JID - 0370507
RN  - EC 3.5.2.6 (beta-Lactamases)
SB  - IM
MH  - Adult
MH  - Carrier State/*diagnosis
MH  - Cross Infection/*microbiology
MH  - Enterobacter cloacae/enzymology
MH  - Enterobacteriaceae/classification/*enzymology
MH  - Enterobacteriaceae Infections/classification/*microbiology
MH  - Female
MH  - French Guiana/epidemiology
MH  - Humans
MH  - *Intensive Care Units
MH  - Klebsiella pneumoniae/enzymology
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Pseudomonas aeruginosa/enzymology
MH  - Staphylococcus aureus/enzymology
MH  - *beta-Lactamases
PMC - PMC8832904
EDAT- 2022/01/11 06:00
MHDA- 2022/03/09 06:00
PMCR- 2022/01/10
CRDT- 2022/01/10 20:35
PHST- 2020/11/13 00:00 [received]
PHST- 2021/03/28 00:00 [accepted]
PHST- 2022/01/11 06:00 [pubmed]
PHST- 2022/03/09 06:00 [medline]
PHST- 2022/01/10 20:35 [entrez]
PHST- 2022/01/10 00:00 [pmc-release]
AID - tpmd201436 [pii]
AID - 10.4269/ajtmh.20-1436 [doi]
PST - epublish
SO  - Am J Trop Med Hyg. 2022 Jan 10;106(2):525-531. doi: 10.4269/ajtmh.20-1436.