Li et al identified risk factors for a pediatric patient being colonized with an extended-spectrum beta-lactamase-producing Enterobacteriaceae on admission to the intensive care unit (ICU). A patient in the ICU who is colonized with an ESBL Enterobacteriaceae is at increased risk for a serious infection with the organism. The authors are from the Johns Hopkins University in Baltimore.

Patient selection: pediatric patient admitted to the ICU


Risk factors for being colonized with an extended-beta-lactamase (ESBL) producing Enterobacteriaceae:

(1) history of being hospitalized in a foreign country (India, Middle East, Southeast Asia, other)

(2) sepsis as the reason for ICU admission

(3) history of hematopoietic stem cell transplant in the past 12 months

(4) history of chemotherapy in the past 6 months

(5) history of infection or being colonized with an ESBL producing Enterobacteriaceae in the past 6 months

(6) history of carbapenem therapy in the past 6 months


A pediatric patient who was previously healthy is at low risk for being colonized.


A patient with one or more of these risk factors should be screened on admission for ESBL producing Enterobacteriaceae.

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