Surveillance Cultures for Management of Multidrug-Resistant Gram-negative Bacilli
MDR Gram-negative bacilli are notorious causes of nosocomial infections and are increasingly jeopardizing patients. Surveillance cultures may lead to the identification of MDR and subsequent appropriate treatment in case of an infection. An overview of studies focusing on the usefulness of surveillance cultures in MDR Gram-negative bacilli infections is provided in Table 3. Overall, only quasi-experimental observational studies were available, studies were difficult to compare and results were frequently inconsistent. Nevertheless, specificity and negative predictive values appeared high, sensitivity moderate and positive predictive value low. Two studies demonstrated that appropriate antibiotic therapy was given more frequently to patients when surveillance cultures correctly predicted the micro-organism causing bacteremia. Acknowledging that they were neither designed nor powered for mortality, two studies failed to demonstrate impact on mortality. Additional studies are needed to establish the role of surveillance cultures for these micro-organisms, as it may have some beneficial aspects, especially in antibiotic guidance.