{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:39:21Z","timestamp":1790775561878,"version":"4.1.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Minist\u00e8re de la Recherche et de l\u2019Enseignement sup\u00e9rieur, Direction G\u00e9n\u00e9rale de l\u2019Offre de Soins"},{"DOI":"10.13039\/501100001677","name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001677","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010066","name":"Conseil R\u00e9gional du Limousin","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Considering the increase in MDR Gram-negative bacteria (GNB), the choice of empirical antibiotic therapy is challenging. In parallel, use of broad-spectrum antibiotics should be avoided to decrease antibiotic selection pressure. Accordingly, clinicians need rapid diagnostic tools to narrow antibiotic therapy. Class 1\u20133 integrons, identified by intI1\u20133 genes, are genetic elements that play a major role in antibiotic resistance in GNB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The objective of the IRIS study was to evaluate the negative and positive predictive values (NPVs and PPVs, respectively) of intI1\u20133 as markers of antibiotic resistance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The IRIS study was an observational cross-sectional multicentre study that enrolled adult subjects with suspected urinary tract or intra-abdominal infections. intI1\u20133 were detected directly from routinely collected biological samples (blood, urine or intra-abdominal fluid) using real-time PCR. A patient was considered \u2018MDR positive\u2019 if at least one GNB, expressing acquired resistance to at least two antibiotic families among \u03b2-lactams, aminoglycosides, fluoroquinolones and\/or co-trimoxazole, was isolated from at least one biological sample.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Over a 2\u2009year period, 513 subjects were enrolled and 409 had GNB documentation, mostly Enterobacterales. intI1 and\/or intI2 were detected in 31.8% of patients and 24.4% of patients were considered \u2018MDR positive\u2019. The NPV of intI1 and\/or intI2 as a marker of acquired antibiotic resistances was estimated at 92.8% (89.1%\u201395.5%). The NPVs for first-line antibiotics were all above 92%, notably &amp;gt;96% for resistance to third-generation cephalosporins.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The IRIS study strongly suggests that the absence of intI1 and intI2 in biological samples from patients with GNB-related infections is predictive of the absence of acquired resistances.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkab348","type":"journal-article","created":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T12:09:01Z","timestamp":1631189341000},"page":"213-217","source":"Crossref","is-referenced-by-count":14,"title":["Integrons, a predictive biomarker for antibiotic resistance in acute sepsis: the IRIS study"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2015-9206","authenticated-orcid":false,"given":"Olivier","family":"Barraud","sequence":"first","affiliation":[{"name":"Universit\u00e9 Limoges, INSERM, CHU Limoges, UMR 1092, Limoges, France"},{"name":"INSERM, CIC1435, CHU Limoges, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elie","family":"Guichard","sequence":"additional","affiliation":[{"name":"INSERM, CIC1415, CHU Tours, Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Chainier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Limoges, INSERM, CHU Limoges, UMR 1092, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Postil","sequence":"additional","affiliation":[{"name":"INSERM, CIC1435, CHU Limoges, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lo\u00efc","family":"Chimot","sequence":"additional","affiliation":[{"name":"CH P\u00e9rigueux, R\u00e9animation, P\u00e9rigueux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Mercier","sequence":"additional","affiliation":[{"name":"CHU Tours, M\u00e9decine intensive\u2014R\u00e9animation, Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Pierre","family":"Frat","sequence":"additional","affiliation":[{"name":"CHU Poitiers, R\u00e9animation m\u00e9dicale et m\u00e9decine interne, Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Desachy","sequence":"additional","affiliation":[{"name":"CH Angoul\u00eame, R\u00e9animation Polyvalente, Angoul\u00eame, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Claude","family":"Lacherade","sequence":"additional","affiliation":[{"name":"CH La Roche-sur-Yon, R\u00e9animation Polyvalente, La Roche-sur-Yon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armelle","family":"Mathonnet","sequence":"additional","affiliation":[{"name":"CH Orl\u00e9ans, M\u00e9decine intensive R\u00e9animation, Orl\u00e9ans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Bellec","sequence":"additional","affiliation":[{"name":"CH Montauban, R\u00e9animation\u2014Surveillance continue, Montauban, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Giraudeau","sequence":"additional","affiliation":[{"name":"INSERM, CIC1415, CHU Tours, Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-C\u00e9cile","family":"Ploy","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Limoges, INSERM, CHU Limoges, UMR 1092, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2531-1652","authenticated-orcid":false,"given":"Bruno","family":"Fran\u00e7ois","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Limoges, INSERM, CHU Limoges, UMR 1092, Limoges, France"},{"name":"INSERM, CIC1435, CHU Limoges, Limoges, France"},{"name":"CHU Limoges, R\u00e9animation Polyvalente, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Iris Study 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