{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T20:57:20Z","timestamp":1790456240509,"version":"4.1.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:p>\n                    The detection of carbapenemase extended-spectrum \u03b2-lactamase (ESBL)-producing\n                    <jats:italic toggle=\"yes\">Enterobacterales<\/jats:italic>\n                    (EB) has become a major issue among critically ill patients, especially due to their impact on appropriate antimicrobial therapy. This study aimed at evaluating the potential contribution of molecular assays to early optimization of empirical antibiotic therapy among critically ill patients with carbapenemase- and\/or CTX-M-producing EB pneumonia. The CRE and ESBL ELITe MGB\n                    <jats:sup>\u00ae<\/jats:sup>\n                    assays were evaluated directly on 197 bronchoalveolar lavage (BAL) samples obtained from 120 patients. Molecular results were then compared to routine culture-based diagnostic results, and a retrospective analysis of the therapeutic antimicrobial management was performed. Among the 197 clinical specimens,\n                    <jats:italic toggle=\"yes\">\n                      bla\n                      <jats:sub>KPC-like<\/jats:sub>\n                    <\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>CTX-M-like<\/jats:sub>\n                    were detected in 20 (10.2%) and 12 (6.1%) specimens belonging to 15 and 11 patients, respectively. Positive predictive value (PPV) and negative predictive value (NPV) of the CRE ELITe MGB Kit were 85% [95% confidence interval [CI]: 64.9\u201394.6] and 100%, respectively. PPV and NPV of the ESBL ELITe MGB Kit were 75% [95% CI: 49.4\u201390.2] and 100%, respectively. Retrospective analysis of the therapeutic antimicrobial management at the time of BAL collection showed that in \u223c50% of patients with carbapenemase- and CTX-M-producing EB pneumonia empirical antibiotic therapy could have been optimized at least 48\u201372\u2009hr earlier if positive molecular data had been used. The CRE and ESBL ELITe MGB assays might be an interesting tool for expediting optimization of empirical antibiotic therapy in critically ill patients with pneumonia, depending on local epidemiology of antibiotic resistance, patient risk stratification for EB infection, and availability of an antimicrobial stewardship team.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2020.0199","type":"journal-article","created":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T17:01:16Z","timestamp":1594141276000},"page":"241-246","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Detection of Carbapenemase and CTX-M Encoding Genes Directly from Bronchoalveolar Lavage Using the CRE and ESBL ELITe MGB Assays: Toward Early and Optimal Antibiotic Therapy Management of Critically Ill Patients with Pneumonia"],"prefix":"10.1177","volume":"27","author":[{"given":"Matteo","family":"Boattini","sequence":"first","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Bianco","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Iannaccone","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Zanotto","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Sidoti","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 4, Hospital de Santa Marta, Central Lisbon Hospital Centre, Lisbon, Portugal."},{"name":"NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Giuseppe","family":"De Rosa","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Unit of Infectious Diseases, University of Turin, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Costa","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,7,7]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.05.021"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1523-3"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2005.08.005"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/0972-5229.130570"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2019.00482"},{"key":"e_1_3_3_7_2","first-page":"15","article-title":"The risk factors for hospital-acquired pneumonia in the intensive care unit","volume":"70","author":"Wa\u0142aszek M.","year":"2016","unstructured":"Wa\u0142aszek M., , Kosiarska A., , Gniadek A., , Ko\u0142pa M., , Wolak Z., , Dobro\u015b W., , and Siadek J.. 2016. The risk factors for hospital-acquired pneumonia in the intensive care unit. Przegl Epidemiol. 70:15\u201320.","journal-title":"Przegl Epidemiol"},{"key":"e_1_3_3_8_2","first-page":"385","article-title":"Risk stratification and treatment of ICU-acquired pneumonia caused by multidrug-resistant\/extensively drug-resistant\/pandrug-resistant bacteria","volume":"24","author":"Bassetti M.","year":"2018","unstructured":"Bassetti M., , Righi E., , Vena A., , Graziano E., , Russo A., , and Peghin M.. 2018. Risk stratification and treatment of ICU-acquired pneumonia caused by multidrug-resistant\/extensively drug-resistant\/pandrug-resistant bacteria. Curr Opin Crit Care. 24:385\u2013393.","journal-title":"Curr Opin Crit Care"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-018-0609-x"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2019.03.007"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2019.01.009"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.02.007"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0168473"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02409-12"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0170033"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2019.12.025"},{"key":"e_1_3_3_17_2","unstructured":"EUCAST 2020. Available at www.eucast.org\/fileadmin\/src\/media\/PDFs\/EUCAST_files\/Breakpoint_tables\/v_10.0_Breakpoint_Tables.pdf"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2018.02.001"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2017.08.030"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00079-17"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13594"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.14822.1"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000598"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw353"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00582-2017"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201708-1717LE"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000596"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01144-2016"},{"key":"e_1_3_3_29_2","doi-asserted-by":"crossref","unstructured":"Douglas I.S. New diagnostic methods for pneumonia in the ICU. Curr Opin Infect Dis 2016;29:197\u2013204.","DOI":"10.1097\/QCO.0000000000000249"},{"key":"e_1_3_3_30_2","first-page":"S1198","article-title":"Rapid microbiological tests for bloodstream infections due to multidrug resistant Gram-negative bacteria: therapeutic implications","author":"Giacobbe D.R.","year":"2019","unstructured":"Giacobbe D.R., , Giani T., , Bassetti M., , Marchese A., , Viscoli C., , and Rossolini G.M.. 2019. Rapid microbiological tests for bloodstream infections due to multidrug resistant Gram-negative bacteria: therapeutic implications. Clin Microbiol Infect. pii:S1198\u2013743X(19)30524\u201330525.","journal-title":"Clin Microbiol Infect"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2020.02.009"},{"key":"e_1_3_3_32_2","doi-asserted-by":"crossref","unstructured":"Saliba R. Aho-Gl\u00e9l\u00e9 L.S Karam-Sarkis D. and Zahar J.R.. 2019. Evaluation of polymerase chain reaction assays for direct screening of carbapenemase-producing Enterobacteriaceae from rectal swabs: a diagnostic meta-analysis. J Hosp Infect. https:\/\/doi.org\/10.1016\/j.jhin.2019.11.017.","DOI":"10.1016\/j.jhin.2019.11.017"}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/mdr.2020.0199","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2020.0199","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2020.0199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:38:00Z","timestamp":1777667880000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/mdr.2020.0199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,7]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2,1]]}},"alternative-id":["10.1089\/mdr.2020.0199"],"URL":"https:\/\/doi.org\/10.1089\/mdr.2020.0199","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,7]]}}}