Should We Screen Patients for Extended-Spectrum β-Lactamase–Producing Enterobacteriaceae in Intensive Care Units?

Meyer, Elisabeth; Serr, Annerose; Schneider, Christian; Utzolino, Stefan; Kern, Winfried V.; Scholz, Robert; Dettenkofer, Markus

doi:10.1086/592702

Cited by 14 publications

(11 citation statements)

References 6 publications

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“…While definitive guidelines for the management of patients infected with ESBL-producing bacteria are still awaited, there is strong evidence that failure to detect ESBL-mediated resistance can lead to treatment failure (13). The use of surveillance cultures or of targeted screening for ESBL producers in high-risk patients or in high-risk units such as intensive care units has been advocated to prevent or control outbreaks of nosocomial infections with these organisms (10,11).…”

mentioning

confidence: 99%

Evaluation of Brilliance ESBL Agar, a Novel Chromogenic Medium for Detection of Extended-Spectrum-Beta- Lactamase-Producing Enterobacteriaceae

et al. 2010

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The aim of this study was to evaluate the performance of Brilliance ESBL agar (OX; Oxoid, Basingstoke, United Kingdom), a novel chromogenic agar for the selective isolation and the presumptive identification of extended-spectrum-beta-lactamase (ESBL)-producing Enterobacteriaceae. A panel of 200 clinical Gram-negative Enterobacteriaceae and nonfermenting isolates with defined resistance mechanisms was inoculated onto OX and onto ChromID ESBL agar (BM; bioMérieux, Marcy l'Etoile, France) chromogenic medium in the first part of the study to evaluate the growth selectivity and chromogenic features of these two media. Of the 156 Enterobacteriaceae challenge isolates, 8 fully susceptible isolates were inhibited, all 98 ESBL producers were detected, and 50 isolates harboring other resistance mechanisms were recovered on both chromogenic agars. In the second phase, 528 clinical samples (including 344 fecal specimens) were plated onto OX, BM, and MacConkey agar with a ceftazidime disk (MCC) for the screening of ESBL-producing Enterobacteriaceae. Growth on at least one medium was observed with 144 (27%) of the clinical samples screened. A total of 182 isolates, including 109 (60%) of Enterobacteriaceae, were recovered and 70 of these (from 59 specimens) were confirmed as ESBL-producing isolates. The sensitivities of MCC, BM, and OX were 74.6%, 94.9%, and 94.9%, respectively. The specificities of MCC, BM, and OX by specimens reached 94.9%, 95.5%, and 95.7%, respectively, when only colored colonies were considered on the two selective chromogenic media. The high negative predictive value (99.3%) found for OX suggests that this medium may constitute an excellent screening tool for the rapid exclusion of patients not carrying ESBL producers.

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confidence: 99%

Evaluation of Brilliance ESBL Agar, a Novel Chromogenic Medium for Detection of Extended-Spectrum-Beta- Lactamase-Producing Enterobacteriaceae

et al. 2010

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“…It can be expected that more cases of ESBL and VRE would be identified if a general admission screening were in place. The usefulness of general screening at admission, however, remains a Increase of patients co-colonised or co-infected 505 matter of debate and its cost-effectiveness has yet to be proven [10]. According to Harris et al, isolating patients colonised by VRE would isolate 47% of the ESBL patients without the need for further testing [8].…”

Section: Discussionmentioning

confidence: 99%

Increase of patients co-colonised or co-infected with methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium or extended-spectrum β-lactamase-producing Enterobacteriaceae

et al. 2011

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“…besiedelt) [204]. In einer kleineren Studie von 4 Intensivstationen in Deutschland erkrankten 25 % der mit ESBL-positiven Erregern besiedelten Patienten an einer Infektion (Harnwegs-und Wundinfektionen, Pneumonie und Pleuraempyem) [207]. [223].…”

Section: Neben Patienteneigenenunclassified

“…Sie empfahlen ein Screeningprogramm für Patienten mit erhöh-tem Infektionsrisiko als Grundlage für eine empirische Therapie bei Infektionen [207].…”

Section: Effektivität Von Aktiver Surveillanceunclassified

Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

2012

Bundesgesundheitsbl.

287

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Should We Screen Patients for Extended-Spectrum β-Lactamase–Producing Enterobacteriaceae in Intensive Care Units?

Cited by 14 publications

References 6 publications

Evaluation of Brilliance ESBL Agar, a Novel Chromogenic Medium for Detection of Extended-Spectrum-Beta- Lactamase-Producing Enterobacteriaceae

Evaluation of Brilliance ESBL Agar, a Novel Chromogenic Medium for Detection of Extended-Spectrum-Beta- Lactamase-Producing Enterobacteriaceae

Increase of patients co-colonised or co-infected with methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium or extended-spectrum β-lactamase-producing Enterobacteriaceae

Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

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