Guidelines for the diagnosis, treatment, prevention and control of infections caused by carbapenem-resistant gram-negative bacilli

Mei Zeng; Jun Xia; Zhiyong Zong; Yi Shi; Yuxing Ni; Fupin Hu; Yijian Chen; Chao Zhuo; Bijie Hu; Xiaoju Lv; Jiabin Li; Zhengyin Liu; Jing Zhang; Wenjie Yang; Fan Yang; Qiwen Yang; Hua Zhou; Xin Li; Jianhua Wang; Yimin Li; Jian'an Ren; Baiyi Chen; Dechang Chen; Anhua Wu; Xiangdong Guan; Jieming Qu; Depei Wu; Xiaojun Huang; Haibo Qiu; Yingchun Xu; Yunsong Yu; Minggui Wang

Journal of Microbiology, Immunology and Infection (Aug 2023)

Guidelines for the diagnosis, treatment, prevention and control of infections caused by carbapenem-resistant gram-negative bacilli

Mei Zeng,
Jun Xia,
Zhiyong Zong,
Yi Shi,
Yuxing Ni,
Fupin Hu,
Yijian Chen,
Chao Zhuo,
Bijie Hu,
Xiaoju Lv,
Jiabin Li,
Zhengyin Liu,
Jing Zhang,
Wenjie Yang,
Fan Yang,
Qiwen Yang,
Hua Zhou,
Xin Li,
Jianhua Wang,
Yimin Li,
Jian'an Ren,
Baiyi Chen,
Dechang Chen,
Anhua Wu,
Xiangdong Guan,
Jieming Qu,
Depei Wu,
Xiaojun Huang,
Haibo Qiu,
Yingchun Xu,
Yunsong Yu,
Minggui Wang

Affiliations

Mei Zeng: Department of Infectious Diseases, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 200032, China
Jun Xia: The Nottingham Ningbo GRADE Centre, University of Nottingham Ningbo China, Ningbo, China; Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
Zhiyong Zong: Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, China
Yi Shi: Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
Yuxing Ni: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
Fupin Hu: Institute of Antibiotics, Huashan Hospital, Fudan University, And Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of People's Republic of China, Shanghai 200040, China
Yijian Chen: Institute of Antibiotics, Huashan Hospital, Fudan University, And Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of People's Republic of China, Shanghai 200040, China
Chao Zhuo: Department of Infectious Diseases, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
Bijie Hu: Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Xiaoju Lv: Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, China
Jiabin Li: Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Anhui 230022, China
Zhengyin Liu: Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
Jing Zhang: Institute of Antibiotics, Huashan Hospital, Fudan University, And Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of People's Republic of China, Shanghai 200040, China
Wenjie Yang: Department of Infectious Diseases, Tianjin First Center Hospital, Tianjin 300192, China
Fan Yang: Institute of Antibiotics, Huashan Hospital, Fudan University, And Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of People's Republic of China, Shanghai 200040, China
Qiwen Yang: Department and State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
Hua Zhou: Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
Xin Li: Department of Pharmacy, The Third Hospital of Changsha, Changsha 410015, China
Jianhua Wang: Pharmaceutical Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
Yimin Li: Department of Critical Care Medicine,State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
Jian'an Ren: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
Baiyi Chen: Divison of Infectious Diseases, The First Hospital of China Medical University, Shenyang 110001, China
Dechang Chen: Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
Anhua Wu: Infection Control Center, Xiangya Hospital, Central South University, Changsha 410008, China
Xiangdong Guan: Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
Jieming Qu: Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
Depei Wu: Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
Xiaojun Huang: Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Beijing 100044, China
Haibo Qiu: Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
Yingchun Xu: Department and State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; Co-corresponding author.
Yunsong Yu: Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China; Co-corresponding author.
Minggui Wang: Institute of Antibiotics, Huashan Hospital, Fudan University, And Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of People's Republic of China, Shanghai 200040, China; Co-corresponding author. Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China.

Journal volume & issue: Vol. 56, no. 4
pp. 653 – 671

Abstract

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The dissemination of carbapenem-resistant Gram-negative bacilli (CRGNB) is a global public health issue. CRGNB isolates are usually extensively drug-resistant or pandrug-resistant, resulting in limited antimicrobial treatment options and high mortality. A multidisciplinary guideline development group covering clinical infectious diseases, clinical microbiology, clinical pharmacology, infection control, and guideline methodology experts jointly developed the present clinical practice guidelines based on best available scientific evidence to address the clinical issues regarding laboratory testing, antimicrobial therapy, and prevention of CRGNB infections. This guideline focuses on carbapenem-resistant Enterobacteriales (CRE), carbapenem-resistant Acinetobacter baumannii (CRAB), and carbapenem-resistant Pseudomonas aeruginosa (CRPA). Sixteen clinical questions were proposed from the perspective of current clinical practice and translated into research questions using PICO (population, intervention, comparator, and outcomes) format to collect and synthesize relevant evidence to inform corresponding recommendations. The grading of recommendations, assessment, development and evaluation (GRADE) approach was used to evaluate the quality of evidence, benefit and risk profile of corresponding interventions and formulate recommendations or suggestions. Evidence extracted from systematic reviews and randomized controlled trials (RCTs) was considered preferentially for treatment-related clinical questions. Observational studies, non-controlled studies, and expert opinions were considered as supplementary evidence in the absence of RCTs. The strength of recommendations was classified as strong or conditional (weak). The evidence informing recommendations derives from studies worldwide, while the implementation suggestions combined the Chinese experience. The target audience of this guideline is clinician and related professionals involved in management of infectious diseases.

Published in Journal of Microbiology, Immunology and Infection

ISSN: 1684-1182 (Print)
Publisher: Elsevier
Country of publisher: Hong Kong
LCC subjects: Science: Microbiology
Website: https://www.sciencedirect.com/journal/journal-of-microbiology-immunology-and-infection

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