Abstract：
OBJECTIVE: Risk factors (RFs) associated with infection progression in patients already colonised by carbapenem-resistant Gram-negative bacteria (CRGNB) have been addressed in few and disperse works. The aim of this study is to identify the relevant RFs associated to infection progression in patients with respiratory tract or rectal colonisation.
METHODS: A systematic literature review was developed to identify RFs associated with infection progression in patients with CRGNB respiratory tract or rectal colonisation. Identified RFs were then evaluated and discussed by the expert panel to identify those that are relevant according to the evidence and expert\'s experience.
RESULTS: A total of 8 articles were included for the CRGNB respiratory tract colonisation and 21 for CRGNB rectal colonisation, identifying 19 RFs associated with pneumonia development and 44 RFs associated with infection progression, respectively. After discussion, the experts agreed on 13 RFs to be associated with pneumonia development after respiratory tract CRGNB colonisation and 33 RFs to be associated with infection progression after rectal CRGNB colonisation. Respiratory tract and rectal colonisation, previous stay in the ICU and longer stay in the ICU were classified as relevant RF independently of the pathogen and site of colonisation. Previous exposure to antibiotic therapy or previous carbapenem use were also common relevant RF for patients with CRGNB respiratory tract and rectal colonisation.
CONCLUSIONS: The results of this study may contribute to the early identification of CRGNB colonized patients at higher risk of infection development, favouring time-to-effective therapy and improving health outcomes.
METHODS: A systematic literature review was developed to identify RFs associated with infection progression in patients with CRGNB respiratory tract or rectal colonisation. Identified RFs were then evaluated and discussed by the expert panel to identify those that are relevant according to the evidence and expert\'s experience.
RESULTS: A total of 8 articles were included for the CRGNB respiratory tract colonisation and 21 for CRGNB rectal colonisation, identifying 19 RFs associated with pneumonia development and 44 RFs associated with infection progression, respectively. After discussion, the experts agreed on 13 RFs to be associated with pneumonia development after respiratory tract CRGNB colonisation and 33 RFs to be associated with infection progression after rectal CRGNB colonisation. Respiratory tract and rectal colonisation, previous stay in the ICU and longer stay in the ICU were classified as relevant RF independently of the pathogen and site of colonisation. Previous exposure to antibiotic therapy or previous carbapenem use were also common relevant RF for patients with CRGNB respiratory tract and rectal colonisation.
CONCLUSIONS: The results of this study may contribute to the early identification of CRGNB colonized patients at higher risk of infection development, favouring time-to-effective therapy and improving health outcomes.
摘要：
目的：在碳青霉烯类耐药革兰阴性菌（CRGNB）已经定植的患者中，与感染进展相关的危险因素（RFs）在很少且分散的工作中得到了解决。这项研究的目的是确定与呼吸道或直肠定植患者感染进展相关的相关RF。
方法：进行了系统的文献综述，以确定与CRGNB呼吸道或直肠定植患者感染进展相关的RFs。然后由专家小组评估和讨论确定的RFs，以根据证据和专家经验确定相关的RFs。
结果：共纳入CRGNB呼吸道定植8篇，CRGNB直肠定植21篇。确定19个与肺炎发展相关的RFs和44个与感染进展相关的RFs，分别。经过讨论,专家们一致认为13个RFs与呼吸道CRGNB定植后的肺炎发展相关,33个RFs与直肠CRGNB定植后的感染进展相关.呼吸道和直肠定植，与病原体和定植部位无关，将先前在ICU的住院时间和在ICU的住院时间分类为相关RF。对于CRGNB呼吸道和直肠定植的患者，先前接触抗生素治疗或先前使用碳青霉烯也是常见的相关RF。
结论：这项研究的结果可能有助于早期识别感染发展风险较高的CRGNB定植患者，有利于有效治疗的时间和改善健康结果。
方法：进行了系统的文献综述，以确定与CRGNB呼吸道或直肠定植患者感染进展相关的RFs。然后由专家小组评估和讨论确定的RFs，以根据证据和专家经验确定相关的RFs。
结果：共纳入CRGNB呼吸道定植8篇，CRGNB直肠定植21篇。确定19个与肺炎发展相关的RFs和44个与感染进展相关的RFs，分别。经过讨论,专家们一致认为13个RFs与呼吸道CRGNB定植后的肺炎发展相关,33个RFs与直肠CRGNB定植后的感染进展相关.呼吸道和直肠定植，与病原体和定植部位无关，将先前在ICU的住院时间和在ICU的住院时间分类为相关RF。对于CRGNB呼吸道和直肠定植的患者，先前接触抗生素治疗或先前使用碳青霉烯也是常见的相关RF。
结论：这项研究的结果可能有助于早期识别感染发展风险较高的CRGNB定植患者，有利于有效治疗的时间和改善健康结果。
