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

Society of Bacterial Infection and Resistance of Chinese Medical Association, the Expert Committee on Clinical Use of Antimicrobial Agents and Evaluation of Antimicrobial Resistance of the National Health Commission, the Infectious Diseases Society of Chinese Medical Education Association

Research output: Journal PublicationReview articlepeer-review

21 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)653-671
Number of pages19
JournalJournal of Microbiology, Immunology and Infection
Volume56
Issue number4
DOIs
Publication statusPublished - Aug 2023

Keywords

  • Antimicrobial susceptibility testing
  • Antimicrobial therapy
  • Carbapenem-resistant Pseudomonas aeruginosa
  • Carbapenem-resistant enterobacteriales
  • Carbapenem-resistant gram-negative bacillus
  • Infection control

ASJC Scopus subject areas

  • Immunology and Allergy
  • General Immunology and Microbiology
  • Microbiology (medical)
  • Infectious Diseases

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