Empirical antimicrobial therapy based on active surveillance cultures in ICU patients

Main Article Content

Alice Ramos Silva
https://orcid.org/0000-0001-6037-8206
Luis Phillipe Nagem Lopes
Fernando Fernandez-Llimos
https://orcid.org/0000-0002-8529-9595
Elisangela Costa Lima
https://orcid.org/0000-0002-0101-790X

Abstract

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.



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1.
Ramos Silva A, Nagem Lopes LP, Fernandez-Llimos F, Costa Lima E. Empirical antimicrobial therapy based on active surveillance cultures in ICU patients. HSJ [Internet]. 2023 Jun. 20 [cited 2024 Nov. 2];13(2):19-24. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1379
Section
ORIGINAL ARTICLE
Author Biographies

Alice Ramos Silva, Federal University of Rio de Janeiro

Master in Pharmaceutical Science and Technology and PhD student and in the Graduate Program in Pharmaceutical Sciences.

Luis Phillipe Nagem Lopes, Federal University of Rio de Janeiro

Bachelor in Pharmacy from the Federal University of Rio de Janeiro.

Fernando Fernandez-Llimos, University of Porto

Professor titular at the Faculty of Pharmacy of the University of Porto.

Elisangela Costa Lima , Federal University of Rio de Janeiro

Adjunct Professor at the Faculty of Pharmacy at the Federal University of Rio de Janeiro.

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