RT Journal Article
T1 Risk factors for carbapenem-resistant Gram-negative bacterial infections: a systematic review.
A1 Palacios-Baena, Zaira R
A1 Giannella, Maddalena
A1 Manissero, Davide
A1 Rodríguez-Baño, Jesus
A1 Viale, Pierluigi
A1 Lopes, Sara
A1 Wilson, Katy
A1 McCool, Rachael
A1 Longshaw, Christopher
K1 Antimicrobial resistance
K1 Carbapenem
K1 Colonization
K1 Healthcare exposure
K1 ICU stay
K1 Invasive devices
K1 Mechanical ventilation
K1 Resistance
K1 Risk factors
K1 Systematic review
AB Rapid and widespread increases in carbapenem resistance (CR) necessitate identification of risk factors to guide appropriate interventions. We aimed to identify risk factors for CR Gram-negative infection through a systematic literature review. We searched MEDLINE (via OvidSP and PubMed) and Embase (via OvidSP) databases and the Cochrane Central Register of Controlled Trials. 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. Studies included hospitalized patients with CR infection caused by Gram-negative bacterial pathogens (Enterobacterales and non-fermenters). 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. 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. Several variables, particularly previous antibiotic use, are strong risk factors for CR infection. Interventions to mitigate against CR infection should target these factors.
YR 2020
FD 2020-10-23
LK http://hdl.handle.net/10668/16515
UL http://hdl.handle.net/10668/16515
LA en
DS RISalud
RD Apr 5, 2025