Abstract
Objective: To assess the predictive value of prior carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA) colonization established in surveillance cultures for subsequent infection by these pathogens in ICU patients. Methods: A cohort study was performed with patients admitted to the intensive care unit for at least 48 h. Negative and positive predictive values, sensitivity, and specificity of surveillance cultures in CRAB and CRPA were measured. Results: 693 infected patients were included. Patients previously colonized by CRAB and CRPA were more likely to be infected by these pathogens: adjusted OR: 10.34 (6.58 - 16.45; p < 0.001) and 2.30 (3.88 - 10.26; p < 0.001), respectively. We found high negative predictive values of surveillance cultures for CRAB (87.18%) and CRPA (88.30%) and high specificity 91.96% and 90.13%, respectively. Conclusions: Patients not colonized by CRAB and CRPA were less prone to infection by these pathogens. These findings may contribute to the choice of empirical antimicrobial therapy and discourage the prescription of antibiotics against these pathogens in patients without previous colonization.
Funder
Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro
Publisher
Revista Ciencias em Saude
Reference40 articles.
1. Multidrug-resistant gram-negative organisms: a review of recently approved antibiotics and novel pipeline agents
2. Centers for Disease Control and Prevention. Antibiotic Resistance Threatens Everyone. Centers for Disease Control and Prevention [Internet]. [cited 24 Jun 2024]. Available from: https://www.cdc.gov/drugresistance/index.html
3. World Health Organization. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level [Internet]. 1 Nov 2016 [cited 25 May 2023] Available at https://www.who.int/publications-detail-redirect/9789241549929
4. Role of surveillance cultures in infection control
5. The “Old” and the “New” Antibiotics for MDR Gram-Negative Pathogens: For Whom, When, and How