Screening for Intestinal Carriage of Extended-spectrum Beta-lactamase-producing Enterobacteriaceae in Critically Ill Patients: Expected Benefits and Evidence-based Controversies.

Details

Serval ID
serval:BIB_A0D0DAEA2D32
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Screening for Intestinal Carriage of Extended-spectrum Beta-lactamase-producing Enterobacteriaceae in Critically Ill Patients: Expected Benefits and Evidence-based Controversies.
Journal
Clinical infectious diseases
Author(s)
Zahar J.R., Blot S., Nordmann P., Martischang R., Timsit J.F., Harbarth S., Barbier F.
ISSN
1537-6591 (Electronic)
ISSN-L
1058-4838
Publication state
Published
Issued date
30/05/2019
Peer-reviewed
Oui
Volume
68
Number
12
Pages
2125-2130
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The rising burden of intensive care unit (ICU)-acquired infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) strengthens the requirement for efficient prevention strategies. The detection of intestinal carriage of ESBL-E through active surveillance cultures (ASC) and the implementation of contact precautions (CP) in carriers are currently advocated in most high-income countries, to prevent cross-transmission and subsequent ESBL-E infections in critically-ill patients. Yet, recent studies have challenged the benefit of ASC and CP in controlling the spread of ESBL-E in ICUs with high compliance to standard hygiene precautions and no ongoing outbreak of ESBL-producing Klebsiella pneumoniae or Enterobacter spp. Besides, given their debated performance to positively predict which patients are at risk of ESBL-E infections, ASC results appear of limited value to rationalize the empirical use of carbapenems in the ICU, emphasizing the urgent need for novel anticipatory and diagnostic approaches. This Viewpoint article summarizes the available evidence on these issues.
Keywords
carbapenem, contact precautions, critical care, extended-spectrum beta-lactamase, ventilator-associated pneumonia
Pubmed
Web of science
Create date
02/11/2018 16:22
Last modification date
01/10/2019 5:09
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