Zaira R Palacios-Baena1, Maddalena Giannella2, Davide Manissero3, Jesus Rodríguez-Baño4, Pierluigi Viale2, Sara Lopes5, Katy Wilson6, Rachael McCool6, Christopher Longshaw7. 1. Infectious Diseases, Clinical Microbiology and Preventive Medicine Unit, Hospital Universitario Virgen Macarena, Institute of Biomedicine of Seville (IBIS), Seville, Spain. Electronic address: zaira.palacios.baena@hotmail.com. 2. Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola Malpighi, Bologna, Italy. 3. Medical Affairs for Infection and Immune Diagnostics, QIAGEN, London, UK. 4. Department of Medicine, University of Seville, Seville, Spain. 5. Market Access, Shionogi Europe, London, UK. 6. York Health Economics Consortium, University of York, York, UK. 7. Medical Affairs, Shionogi Europe, London, UK.
Abstract
BACKGROUND: Rapid and widespread increases in carbapenem resistance (CR) necessitate identification of risk factors to guide appropriate interventions. OBJECTIVES: We aimed to identify risk factors for CR Gram-negative infection through a systematic literature review. DATA SOURCES: We searched MEDLINE (via OvidSP and PubMed) and Embase (via OvidSP) databases and the Cochrane Central Register of Controlled Trials. STUDY ELIGIBILITY CRITERIA: Prospective or retrospective cohort and case-control studies reporting quantitative data on risk factors associated with infections due to CR Gram-negative pathogens in hospitalized patients were eligible. PARTICIPANTS: Studies included hospitalized patients with CR infection caused by Gram-negative bacterial pathogens (Enterobacterales and non-fermenters). METHODS: Searches were conducted in January 2018/December 2019 to identify studies published since 2007. Risk factor data were extracted and grouped by factor. The primary metric was proportion of studies reporting a significant association with CR infection for each factor. RESULTS: In total, 92 studies were identified. Risk factors most frequently reported as significantly associated with CR infection (>10 studies) were previous antibiotic use (91.1%; 72/79 studies); previous carbapenem use (82.6%; 57/69); previous colonization (72.7%; 8/11); mechanical ventilation (66.7%; 36/54); previous intensive care unit stay (64.4%; 38/59); dialysis (61.1%; 11/18); catheter (58.0%; 40/69); length of stay in hospital (54.5%; 30/55); comorbidities (52.7%; 39/74); APACHE II (51.7%; 15/29); and intubation (51.4%; 18/35). Risk factors were mostly consistent across different species and sites of infection. CONCLUSIONS: Several variables, particularly previous antibiotic use, are strong risk factors for CR infection. Interventions to mitigate against CR infection should target these factors.
BACKGROUND: Rapid and widespread increases in carbapenem resistance (CR) necessitate identification of risk factors to guide appropriate interventions. OBJECTIVES: We aimed to identify risk factors for CR Gram-negative infection through a systematic literature review. DATA SOURCES: We searched MEDLINE (via OvidSP and PubMed) and Embase (via OvidSP) databases and the Cochrane Central Register of Controlled Trials. STUDY ELIGIBILITY CRITERIA: Prospective or retrospective cohort and case-control studies reporting quantitative data on risk factors associated with infections due to CR Gram-negative pathogens in hospitalized patients were eligible. PARTICIPANTS: Studies included hospitalized patients with CR infection caused by Gram-negative bacterial pathogens (Enterobacterales and non-fermenters). METHODS: Searches were conducted in January 2018/December 2019 to identify studies published since 2007. Risk factor data were extracted and grouped by factor. The primary metric was proportion of studies reporting a significant association with CR infection for each factor. RESULTS: In total, 92 studies were identified. Risk factors most frequently reported as significantly associated with CR infection (>10 studies) were previous antibiotic use (91.1%; 72/79 studies); previous carbapenem use (82.6%; 57/69); previous colonization (72.7%; 8/11); mechanical ventilation (66.7%; 36/54); previous intensive care unit stay (64.4%; 38/59); dialysis (61.1%; 11/18); catheter (58.0%; 40/69); length of stay in hospital (54.5%; 30/55); comorbidities (52.7%; 39/74); APACHE II (51.7%; 15/29); and intubation (51.4%; 18/35). Risk factors were mostly consistent across different species and sites of infection. CONCLUSIONS: Several variables, particularly previous antibiotic use, are strong risk factors for CR infection. Interventions to mitigate against CR infection should target these factors.
Authors: Lorenzo Onorato; Bruno Sarnelli; Federica D'Agostino; Giuseppe Signoriello; Ugo Trama; Angelo D'Argenzio; Maria Vittoria Montemurro; Nicola Coppola Journal: Antibiotics (Basel) Date: 2022-05-08
Authors: Emilio Bouza; Arístides de Alarcón; María Carmen Fariñas; Juan Gálvez; Miguel Ángel Goenaga; Francisco Gutiérrez-Díez; Javier Hortal; José Lasso; Carlos A Mestres; José M Miró; Enrique Navas; Mercedes Nieto; Antonio Parra; Enrique Pérez de la Sota; Hugo Rodríguez-Abella; Marta Rodríguez-Créixems; Jorge Rodríguez-Roda; Gemma Sánchez Espín; Dolores Sousa; Carlos Velasco García de Sierra; Patricia Muñoz; Martha Kestler Journal: J Clin Med Date: 2021-11-26 Impact factor: 4.241
Authors: Fatma Ben Abid; Clement K M Tsui; Yohei Doi; Anand Deshmukh; Christi L McElheny; William C Bachman; Erin L Fowler; Ahmed Albishawi; Kamran Mushtaq; Emad B Ibrahim; Sanjay H Doiphode; Manal M Hamed; Muna A Almaslmani; Abdullatif Alkhal; Adeel A Butt; Ali S Omrani Journal: Eur J Clin Microbiol Infect Dis Date: 2021-02-22 Impact factor: 3.267