Empirical antimicrobial therapy based on active surveillance cultures in ICU patients

Autor: Alice Ramos Silva, Luis Phillipe Nagem Lopes, Fernando Fernandez-Llimos, Elisangela Costa Lima
Jazyk: English<br />Portuguese
Rok vydání: 2023
Předmět:
Zdroj: Revista Ciências em Saúde, Vol 13, Iss 2 (2023)
Druh dokumentu: article
ISSN: 2236-3785
DOI: 10.21876/rcshci.v13i2.1379
Popis: 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.
Databáze: Directory of Open Access Journals