Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026
Predictive performance of weekly rectal surveillance cultures and extra-rectal colonization for carbapenem-resistant Enterobacterales infections in a resource-limited ICU with KPC and NDM co-circulation.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Favier Patricio, Suárez-Urquiza Pedro, Raffo Carla, Torres Diego, Kumar Liliana, Pérez Johanna, Primost Ivana, Gallino María Inés, Pinilla-Huayta Fidel, Muñoz-Soto Claudia, Ravelli Matías, Serio Enrique, Pemán-García Javier, Valentín-Martín Amparo, González-Barberá Eva María
Аннотация
BACKGROUND: Carbapenem-resistant Enterobacterales (CRE) cause hard-to-treat infections. Rectal surveillance is widely used to detect carriers, but its predictive value where different carbapenemases co-circulate is unclear. We assessed whether CRE rectal and extra-rectal colonization predicts subsequent infection in an intensive care unit with concurrent KPC and NDM circulation.
METHODS: We performed a retrospective observational study in a 60-bed adult intensive care unit in Buenos Aires, Argentina, from July 2016 to September 2019. All patients underwent weekly rectal surveillance, and extra rectal samples were taken when clinically indicated. Following up lasted 90 days from the first positive culture or from admission for non-carriers. Outcomes were any CRE infection and bacteremia. We estimated predictive values and fitted multivariable logistic regression models.
RESULTS: We included 495 patients, median age 66 years, 58% male. Of them, 66% had rectal colonization and 8% had extra-rectal colonization. CRE rectal carriage showed low PPV for any infection, about 10%, with high NPV near 94%, and it was not independently associated with infection (aOR 1.9 [0.9-4.4], p=0.1). CRE extra-rectal colonization was an independent predictor of any CRE infection (aOR 3.4 [1.4-7.9] p<0.01) and bacteremia (aOR 3.3 [1.3-8.9] p<0.05), with specificity >93% but sensitivity ≈ 20%.
CONCLUSIONS: In this mixed KPC and NDM CRE setting, weekly rectal surveillance was not a predictor of later infection, while extra rectal colonization retained independent predictive value for overall infection and for bacteremia.
METHODS: We performed a retrospective observational study in a 60-bed adult intensive care unit in Buenos Aires, Argentina, from July 2016 to September 2019. All patients underwent weekly rectal surveillance, and extra rectal samples were taken when clinically indicated. Following up lasted 90 days from the first positive culture or from admission for non-carriers. Outcomes were any CRE infection and bacteremia. We estimated predictive values and fitted multivariable logistic regression models.
RESULTS: We included 495 patients, median age 66 years, 58% male. Of them, 66% had rectal colonization and 8% had extra-rectal colonization. CRE rectal carriage showed low PPV for any infection, about 10%, with high NPV near 94%, and it was not independently associated with infection (aOR 1.9 [0.9-4.4], p=0.1). CRE extra-rectal colonization was an independent predictor of any CRE infection (aOR 3.4 [1.4-7.9] p<0.01) and bacteremia (aOR 3.3 [1.3-8.9] p<0.05), with specificity >93% but sensitivity ≈ 20%.
CONCLUSIONS: In this mixed KPC and NDM CRE setting, weekly rectal surveillance was not a predictor of later infection, while extra rectal colonization retained independent predictive value for overall infection and for bacteremia.