2024
WHO global research priorities for antimicrobial resistance in human health
Bertagnolio S, Dobreva Z, Centner C, Olaru I, Donà D, Burzo S, Huttner B, Chaillon A, Gebreselassie N, Wi T, Hasso-Agopsowicz M, Allegranzi B, Sati H, Ivanovska V, Kothari K, Balkhy H, Cassini A, Hamers R, Van Weezenbeek K, Collaborators W, Aanensen D, Alanio A, Alastruey-Izquierdo A, Alemayehu T, Al-Hasan M, Allegaert K, Al-Maani A, Al-Salman J, Alshukairi A, Amir A, Applegate T, Araj G, Villalobos M, Årdal C, Ashiru-Oredope D, Ashley E, Babin F, Bachmann L, Bachmann T, Baker K, Balasegaram M, Bamford C, Baquero F, Barcelona L, Bassat Q, Bassetti M, Basu S, Beardsley J, Vásquez G, Berkley J, Bhatnagar A, Bielicki J, Bines J, Bongomin F, Bonomo R, Bradley J, Bradshaw C, Brett A, Brink A, Brown C, Brown J, Buising K, Carson C, Carvalho A, Castagnola E, Cavaleri M, Cecchini M, Chabala C, Chaisson R, Chakrabarti A, Chandler C, Chandy S, Charani E, Chen L, Chiara F, Chowdhary A, Chua A, Chuki P, Chun D, Churchyard G, Cirillo D, Clack L, Coffin S, Cohn J, Cole M, Conly J, Cooper B, Corso A, Cosgrove S, Cox H, Daley C, Darboe S, Darton T, Davies G, de Egea V, Dedeić-Ljubović A, Deeves M, Denkinger C, Dillon J, Dramowski A, Eley B, Esposito S, Essack S, Farida H, Farooqi J, Feasey N, Ferreyra C, Fifer H, Finlayson H, Frick M, Gales A, Galli L, Gandra S, Gerber J, Giske C, Gordon B, Govender N, Guessennd N, Guindo I, Gurbanova E, Gwee A, Hagen F, Harbarth S, Haze J, Heim J, Hendriksen R, Heyderman R, Holt K, Hönigl M, Hook E, Hope W, Hopkins H, Hughes G, Ismail G, Issack M, Jacobs J, Jasovský D, Jehan F, Pearson A, Jones M, Joshi M, Kapil A, Kariuki S, Karkey A, Kearns G, Keddy K, Khanna N, Kitamura A, Kolho K, Kontoyiannis D, Kotwani A, Kozlov R, Kranzer K, Kularatne R, Lahra M, Langford B, Laniado-Laborin R, Larsson J, Lass-Flörl C, Le Doare K, Lee H, Lessa F, Levin A, Limmathurotsakul D, Lincopan N, Vecchio A, Lodha R, Loeb M, Longtin Y, Lye D, Mahmud A, Manaia C, Manderson L, Mareković I, Marimuthu K, Martin I, Mashe T, Mei Z, Meis J, De Melo F, Mendelson M, Miranda A, Moore D, Morel C, Moremi N, Moro M, Moussy F, Mshana S, Mueller A, Ndow F, Nicol M, Nunn A, Obaro S, Obiero C, Okeke I, Okomo U, Okwor T, Oladele R, Omulo S, Ondoa P, de Canese J, Ostrosky-Zeichner L, Padoveze M, Pai M, Park B, Parkhill J, Parry C, Peeling R, Peixe L, Perovic O, Pettigrew M, Principi N, Pulcini C, Puspandari N, Rawson T, Reddy D, Reddy K, Redner P, Tudela J, Rodríguez-Baño J, Van Katwyk S, Roilides E, Rollier C, Rollock L, Ronat J, Ruppe E, Sadarangani M, Salisbury D, Salou M, Samison L, Sanguinetti M, Sartelli M, Schellack N, Schouten J, Schwaber M, Seni J, Senok A, Shafer W, Shakoor S, Sheppard D, Shin J, Sia S, Sievert D, Singh I, Singla R, Skov R, Soge O, Sprute R, Srinivasan A, Srinivasan S, Sundsfjord A, Tacconelli E, Tahseen S, Tangcharoensathien V, Tängdén T, Thursky K, Thwaites G, de Souza Peral R, Tong D, Tootla H, Tsioutis C, Turner K, Turner P, Omar S, van de Sande W, van den Hof S, van Doorn R, Veeraraghavan B, Verweij P, Wahyuningsih R, Wang H, Warris A, Weinstock H, Wesangula E, Whiley D, White P, Williams P, Xiao Y, Moscoso M, Yang H, Yoshida S, Yu Y, Żabicka D, Zignol M, Rudan I. WHO global research priorities for antimicrobial resistance in human health. The Lancet Microbe 2024, 5: 100902. PMID: 39146948, PMCID: PMC11543637, DOI: 10.1016/s2666-5247(24)00134-4.Peer-Reviewed Original ResearchAntimicrobial resistanceTreatment of antimicrobial-resistant infectionsConsequences of antimicrobial resistanceAntimicrobial resistance epidemiologyAntimicrobial-resistant infectionsDrug-resistant pathogensAntimicrobial resistance dynamicsResearch prioritiesComprehensive scoping reviewGeneration of evidenceGlobal research prioritiesScoping reviewWHOKnowledge gapsExpert inputResearch agendaHealthBurdenPathogensFungal pathogensPolicy translationTuberculosisDiagnosisInfectionParticipant Diversity in United States Randomized Controlled Trials of Antibacterials for Staphylococcus aureus Infections, 2000–2021
Kwon J, Pelletiers W, Peña J, van Duin D, Ledbetter L, Baum K, Ruffin F, Knisely J, Bizzell E, Fowler V, Chambers H, Pettigrew M. Participant Diversity in United States Randomized Controlled Trials of Antibacterials for Staphylococcus aureus Infections, 2000–2021. Clinical Infectious Diseases 2024, 79: 141-147. PMID: 38306502, PMCID: PMC11259209, DOI: 10.1093/cid/ciae049.Peer-Reviewed Original ResearchMethicillin-resistant S. aureusRandomized controlled trialsPhase 2/3 trialsPhase 4 trialIncidence of methicillin-resistant S. aureusTreat Staphylococcus aureus infectionsStaphylococcus aureus infectionStandard of carePercentage of study participantsIncidence ratiosClinical trialsEthnicity of participantsControlled trialsStandardized reporting methodsBlack participantsStudy sizeInfectionDisease populationTrialsStudy participantsAntibacterial agentsIncreased recruitmentIndustry sponsorshipEthnicity dataSex
2023
Priorities and Progress in Gram-positive Bacterial Infection Research by the Antibacterial Resistance Leadership Group: A Narrative Review
Doernberg S, Arias C, Altman D, Babiker A, Boucher H, Creech C, Cosgrove S, Evans S, Fowler V, Fritz S, Hamasaki T, Kelly B, Leal S, Liu C, Lodise T, Miller L, Munita J, Murray B, Pettigrew M, Ruffin F, Scheetz M, Shopsin B, Tran T, Turner N, Williams D, Zaharoff S, Holland T, Patel R, King H, Kinamon T, Dai W, Geres H, Deckard N, Schuler C, Bunn I, Sharma S, Wickward C, Waller J, Wilson H, Mehigan M, Ghazaryan V, Raterman E, Samuel T, Lee M. Priorities and Progress in Gram-positive Bacterial Infection Research by the Antibacterial Resistance Leadership Group: A Narrative Review. Clinical Infectious Diseases 2023, 77: s295-s304. PMID: 37843115, PMCID: PMC10578051, DOI: 10.1093/cid/ciad565.Peer-Reviewed Original ResearchConceptsAntibacterial Resistance Leadership GroupMRSA bloodstream infectionsMethicillin-resistant Staphylococcus aureusBloodstream infectionsClinical trialsPediatric community-acquired pneumoniaInfection researchEnterococcal bloodstream infectionsOptimal vancomycin dosingOptimization of dosingRole of dalbavancinCommunity-acquired pneumoniaShort-course therapyInterventional clinical trialsVancomycin-resistant enterococciVancomycin dosingPositive infectionsNovel agentsLife measuresTreat infectionsClinical practiceNarrative reviewInfectionPositive bacteriaStaphylococcus aureusThe Next Generation: Mentoring and Diversity in the Antibacterial Resistance Leadership Group
Harris A, Souli M, Pettigrew M, Group F. The Next Generation: Mentoring and Diversity in the Antibacterial Resistance Leadership Group. Clinical Infectious Diseases 2023, 77: s331-s335. PMID: 37843116, PMCID: PMC10578050, DOI: 10.1093/cid/ciad532.Peer-Reviewed Original ResearchSevere acute respiratory coronavirus virus 2 (SARS-CoV-2) RNA and viable virus contamination of hospital emergency department surfaces and association with patient coronavirus disease 2019 (COVID-19) status and aerosol-generating procedures
Roberts S, Barbell E, Barber D, Dahlberg S, Heimer R, Jubanyik K, Parwani V, Pettigrew M, Tanner J, Ulrich A, Wade M, Wyllie A, Yolda-Carr D, Martinello R, Tanner W. Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) RNA and viable virus contamination of hospital emergency department surfaces and association with patient coronavirus disease 2019 (COVID-19) status and aerosol-generating procedures. Infection Control And Hospital Epidemiology 2023, 45: 244-246. PMID: 37767709, PMCID: PMC10877528, DOI: 10.1017/ice.2023.183.Peer-Reviewed Original ResearchAdaptation of Nontypeable Haemophilus influenzae in Human Airways in COPD: Genome Rearrangements and Modulation of Expression of HMW1 and HMW2
Murphy T, Kirkham C, D’Mello A, Sethi S, Pettigrew M, Tettelin H. Adaptation of Nontypeable Haemophilus influenzae in Human Airways in COPD: Genome Rearrangements and Modulation of Expression of HMW1 and HMW2. MBio 2023, 14: e00140-23. PMID: 36927061, PMCID: PMC10127715, DOI: 10.1128/mbio.00140-23.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseNontypeable Haemophilus influenzaeObstructive pulmonary diseaseRespiratory epithelial cellsHuman airwaysHaemophilus influenzaeAirway inflammationLung functionMechanisms of persistencePulmonary diseaseEpithelial cellsNovel interventionsChronic lower airway infectionsProgressive lossAirways of adultsLower airway infectionHuman respiratory epithelial cellsCommon debilitating disorderStrains of NTHiNTHi infectionAirway infectionLower airwaysCommon causeSequential isolatesSerial isolates
2022
Impact of antibiotics on off-target infant gut microbiota and resistance genes in cohort studies
Lebeaux RM, Madan JC, Nguyen QP, Coker MO, Dade EF, Moroishi Y, Palys TJ, Ross BD, Pettigrew MM, Morrison HG, Karagas MR, Hoen AG. Impact of antibiotics on off-target infant gut microbiota and resistance genes in cohort studies. Pediatric Research 2022, 92: 1757-1766. PMID: 35568730, PMCID: PMC9659678, DOI: 10.1038/s41390-022-02104-w.Peer-Reviewed Original ResearchConceptsAntibiotic exposureCohort studyDay careDay care attendanceInfant gut microbiotaAntibiotic resistance genesCare attendanceImpact of antibioticsAntibiotic useStool samplesGut microbiotaInfantsGut microbiomeStudy designBacteroides fragilisAntibioticsBackgroundYoung childrenNovel findingsSubsequent exposureExposureFirst yearFurther investigationBaselineResistance genesCareComparison of the Respiratory Resistomes and Microbiota in Children Receiving Short versus Standard Course Treatment for Community-Acquired Pneumonia
Pettigrew MM, Kwon J, Gent JF, Kong Y, Wade M, Williams DJ, Creech CB, Evans S, Pan Q, Walter EB, Martin JM, Gerber JS, Newland JG, Hofto ME, Staat MA, Fowler VG, Chambers HF, Huskins WC. Comparison of the Respiratory Resistomes and Microbiota in Children Receiving Short versus Standard Course Treatment for Community-Acquired Pneumonia. MBio 2022, 13: e00195-22. PMID: 35323040, PMCID: PMC9040816, DOI: 10.1128/mbio.00195-22.Peer-Reviewed Original ResearchConceptsCommunity-acquired pneumoniaShort-course strategyBeta-lactam therapyTreatment strategiesAntibiotic useRespiratory microbiomePediatric community-acquired pneumoniaDays of antibioticsShorter antibiotic coursesStandard-strategy groupDays of therapyStandard treatment strategyAntibiotic resistanceAdditional rationaleEffectiveness of interventionsImpact of durationAntibiotic coursesThroat swabsCourse strategyAntibiotic treatmentPediatric pneumoniaCourse treatmentLow prevalencePneumoniaAntibiotic resistance determinantsGastrointestinal Microbiome Disruption and Antibiotic-Associated Diarrhea in Children Receiving Antibiotic Therapy for Community-Acquired Pneumonia
Kwon J, Kong Y, Wade M, Williams DJ, Creech CB, Evans S, Walter EB, Martin JM, Gerber JS, Newland JG, Hofto ME, Staat MA, Chambers HF, Fowler VG, Huskins WC, Pettigrew M. Gastrointestinal Microbiome Disruption and Antibiotic-Associated Diarrhea in Children Receiving Antibiotic Therapy for Community-Acquired Pneumonia. The Journal Of Infectious Diseases 2022, 226: 1109-1119. PMID: 35249113, PMCID: PMC9492313, DOI: 10.1093/infdis/jiac082.Peer-Reviewed Original ResearchConceptsAAD groupAntibiotic-Associated DiarrheaCommunity-Acquired PneumoniaCommon side effectsStudy days 1Days of diarrheaPatient characteristicsAntibiotic therapyNineteen childrenStool samplesSide effectsDay 1Microbiome disruptionMicrobiota profilesGastrointestinal microbiotaMicrobiota characteristicsDiarrheaBacteroides speciesPneumoniaChildrenAntibioticsΒ-lactamsAADBaseline abundanceDysbiosisShort- vs Standard-Course Outpatient Antibiotic Therapy for Community-Acquired Pneumonia in Children
Williams DJ, Creech CB, Walter EB, Martin JM, Gerber JS, Newland JG, Howard L, Hofto ME, Staat MA, Oler RE, Tuyishimire B, Conrad TM, Lee MS, Ghazaryan V, Pettigrew MM, Fowler VG, Chambers HF, Zaoutis TE, Evans S, Huskins WC, Team A. Short- vs Standard-Course Outpatient Antibiotic Therapy for Community-Acquired Pneumonia in Children. JAMA Pediatrics 2022, 176: 253-261. PMID: 35040920, PMCID: PMC8767493, DOI: 10.1001/jamapediatrics.2021.5547.Peer-Reviewed Original ResearchConceptsChildhood community-acquired pneumoniaAntibiotic-associated adverse effectsShort-course strategyClinical responseAdverse effectsDouble-blind placebo-controlled clinical trialPlacebo-controlled clinical trialEnd pointDays of antibioticsEarly clinical improvementInadequate clinical responseOutpatient antibiotic therapyShorter antibiotic durationsSimilar clinical responseCommunity-Acquired PneumoniaPrimary end pointComposite end pointResolution of symptomsAntibiotic treatment strategiesSubset of childrenAntibiotic daysAntibiotic durationClinical improvementAntibiotic therapyInitial treatment
2021
Bacterial Signatures of Paediatric Respiratory Disease: An Individual Participant Data Meta-Analysis
Broderick DTJ, Waite DW, Marsh RL, Camargo CA, Cardenas P, Chang AB, Cookson WOC, Cuthbertson L, Dai W, Everard ML, Gervaix A, Harris JK, Hasegawa K, Hoffman LR, Hong SJ, Josset L, Kelly MS, Kim BS, Kong Y, Li SC, Mansbach JM, Mejias A, O’Toole G, Paalanen L, Pérez-Losada M, Pettigrew MM, Pichon M, Ramilo O, Ruokolainen L, Sakwinska O, Seed PC, van der Gast CJ, Wagner BD, Yi H, Zemanick ET, Zheng Y, Pillarisetti N, Taylor MW. Bacterial Signatures of Paediatric Respiratory Disease: An Individual Participant Data Meta-Analysis. Frontiers In Microbiology 2021, 12: 711134. PMID: 35002989, PMCID: PMC8733647, DOI: 10.3389/fmicb.2021.711134.Peer-Reviewed Original ResearchPediatric respiratory diseasesIndividual participant dataRespiratory diseaseLower airway samplesIndividual Participant Data Meta-AnalysisChronic respiratory conditionsData Meta-AnalysisPositive predictive valueCross-sectional analysisAirway microbiotaAirway samplesRespiratory conditionsCase subjectsRespiratory microbiotaAnatomical sitesPredictive valueSingle diseaseMeta-AnalysisClinical diagnosisMicrobiota differencesDiseaseDiagnostic groupingsParticipant dataMicrobiota associationsMultiple diseasesAntibacterial Resistance Leadership Group 2.0: Back to Business
Chambers HF, Evans SR, Patel R, Cross HR, Harris AD, Doi Y, Boucher HW, van Duin D, Tsalik EL, Holland TL, Pettigrew MM, Tamma PD, Hodges KR, Souli M, Fowler VG. Antibacterial Resistance Leadership Group 2.0: Back to Business. Clinical Infectious Diseases 2021, 73: 730-739. PMID: 33588438, PMCID: PMC8366825, DOI: 10.1093/cid/ciab141.Peer-Reviewed Original Research
2020
175. Randomized Double-blind Controlled Trial of Short vs. Standard Course Outpatient Therapy of Community Acquired Pneumonia in Children (SCOUT-CAP)
Williams D, Creech C, Walter E, Martin J, Gerber J, Newland J, Howard L, Hofto M, Staat M, Oler R, Conrad T, Tuyishimire B, Pettigrew M, Fowler V, Chambers H, Zaoutis T, Evans S, Huskins W. 175. Randomized Double-blind Controlled Trial of Short vs. Standard Course Outpatient Therapy of Community Acquired Pneumonia in Children (SCOUT-CAP). Open Forum Infectious Diseases 2020, 7: s216-s216. PMCID: PMC7776421, DOI: 10.1093/ofid/ofaa439.485.Peer-Reviewed Original ResearchShort-course therapyCourse therapyAntibiotic exposureClinical improvementOutpatient therapyAdverse effectsDouble-blind Controlled TrialPlacebo-controlled superiority trialDays of antibioticsInitial clinical improvementShort antibiotic exposureShorter antibiotic coursesCommunity-Acquired PneumoniaStart of therapyCAP treatmentChildren ages 6Antibiotic coursesInitial therapyAcquired PneumoniaBaseline characteristicsClinical responseSecondary outcomesStandard therapyControlled TrialsPrimary outcomeThe Lung Microbiome and Pneumonia
Pettigrew MM, Tanner W, Harris AD. The Lung Microbiome and Pneumonia. The Journal Of Infectious Diseases 2020, 223: s241-s245. PMID: 33330898, DOI: 10.1093/infdis/jiaa702.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsDolosigranulum pigrum Cooperation and Competition in Human Nasal Microbiota
Brugger SD, Eslami SM, Pettigrew MM, Escapa IF, Henke MT, Kong Y, Lemon KP. Dolosigranulum pigrum Cooperation and Competition in Human Nasal Microbiota. MSphere 2020, 5: 10.1128/msphere.00852-20. PMID: 32907957, PMCID: PMC7485692, DOI: 10.1128/msphere.00852-20.Peer-Reviewed Original ResearchConceptsMicrobe-microbe interactionsHuman nasal microbiotaGenomic analysisPhenotypic interactionsBiosynthetic gene clusterSmall genomesNasal microbiotaGene clusterAccessory genomeKey nutrientsNew insightsGenomic capacityBacterial residentsPathogenic speciesNasal microbiota compositionBeneficial bacteriumFunctional assaysDiverse repertoireHuman hostGenomeSpeciesAcid productionMicrobiotaNasal bacteriaBacteria
2019
Non-typeable Haemophilus influenzae isolates from patients with chronic obstructive pulmonary disease contain new phase-variable modA methyltransferase alleles controlling phasevarions
Atack JM, Murphy TF, Pettigrew MM, Seib KL, Jennings MP. Non-typeable Haemophilus influenzae isolates from patients with chronic obstructive pulmonary disease contain new phase-variable modA methyltransferase alleles controlling phasevarions. Scientific Reports 2019, 9: 15963. PMID: 31685916, PMCID: PMC6828955, DOI: 10.1038/s41598-019-52429-6.Peer-Reviewed Original ResearchConceptsNon-typeable Haemophilus influenzaeChronic obstructive pulmonary diseaseObstructive pulmonary diseaseMiddle ear infectionPulmonary diseaseEar infectionsNTHi strainsHaemophilus influenzaeExacerbation of COPDCOPDMiddle earPatientsAllele distributionInfectionInfluenzaeBacterial pathogensDiseaseMultiple allelic variantsAllelic variantsGene expressionAllelesEpigenetic mechanismsLarge panelExacerbationExpressionDiscovery and Contribution of Nontypeable Haemophilus influenzae NTHI1441 to Human Respiratory Epithelial Cell Invasion
Ahearn C, Kirkham C, Chaves L, Kong Y, Pettigrew M, Murphy T. Discovery and Contribution of Nontypeable Haemophilus influenzae NTHI1441 to Human Respiratory Epithelial Cell Invasion. Infection And Immunity 2019, 87: 10.1128/iai.00462-19. PMID: 31427451, PMCID: PMC6803334, DOI: 10.1128/iai.00462-19.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseRespiratory epithelial cellsEnzyme-linked immunosorbent assayEpithelial cellsAirways of adultsObstructive pulmonary diseaseCell invasionHuman respiratory epithelial cellsNontypeable Haemophilus influenzaeCell enzyme-linked immunosorbent assayAlveolar epithelial cellsAcute exacerbationLower airwaysPulmonary diseaseSerum IgGNTHi strainsTherapeutic interventionsHaemophilus influenzaeHuman bronchialSurface-exposed epitopesEpithelial cell invasionIsogenic knockout mutantsNTHiImmunosorbent assayIntracellular survivalTranscriptome Sequencing Data Sets for Determining Gene Expression Changes Mediated by Phase-Variable DNA Methyltransferases in Nontypeable Haemophilus influenzae Strains Isolated from Patients with Chronic Obstructive Pulmonary Disease
Atack JM, Murphy TF, Pettigrew MM, Seib KL, Jennings MP. Transcriptome Sequencing Data Sets for Determining Gene Expression Changes Mediated by Phase-Variable DNA Methyltransferases in Nontypeable Haemophilus influenzae Strains Isolated from Patients with Chronic Obstructive Pulmonary Disease. Microbiology Resource Announcements 2019, 8: 10.1128/mra.00526-19. PMID: 31320413, PMCID: PMC6639615, DOI: 10.1128/mra.00526-19.Peer-Reviewed Original ResearchChronic obstructive pulmonary diseaseObstructive pulmonary diseasePulmonary diseaseNontypeable Haemophilus influenzae strainHaemophilus influenzae strainsMajor bacterial causesBacterial causeNTHi strainsGene expression changesDiseaseGene expression differencesFuture studiesExpression changesExpression differencesExacerbationPatients
2018
Persistence of Moraxella catarrhalis in Chronic Obstructive Pulmonary Disease and Regulation of the Hag/MID Adhesin
Murphy TF, Brauer AL, Pettigrew MM, LaFontaine ER, Tettelin H. Persistence of Moraxella catarrhalis in Chronic Obstructive Pulmonary Disease and Regulation of the Hag/MID Adhesin. The Journal Of Infectious Diseases 2018, 219: 1448-1455. PMID: 30496439, PMCID: PMC6467191, DOI: 10.1093/infdis/jiy680.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseObstructive pulmonary diseaseM. catarrhalisPulmonary diseaseMoraxella catarrhalisPersistent strainsDuration of persistenceHuman airwaysCatarrhalisCessation of expressionAirwayMajor pathogenPatientsBacterial pathogensDiseaseVirulence-associated phenotypesAdultsCollected strainsMost strainsExpressionHuman cellsPathogensPathogenesisPersistenceMonthsGastrointestinal Microbiota Disruption and Risk of Colonization With Carbapenem-resistant Pseudomonas aeruginosa in Intensive Care Unit Patients
Pettigrew MM, Gent JF, Kong Y, Halpin AL, Pineles L, Harris AD, Johnson JK. Gastrointestinal Microbiota Disruption and Risk of Colonization With Carbapenem-resistant Pseudomonas aeruginosa in Intensive Care Unit Patients. Clinical Infectious Diseases 2018, 69: 604-613. PMID: 30383203, PMCID: PMC6669284, DOI: 10.1093/cid/ciy936.Peer-Reviewed Original ResearchConceptsCarbapenem-resistant Pseudomonas aeruginosaIntensive care unit patientsCare unit patientsPiperacillin-tazobactamUnit patientsICU patientsMarker of riskMaryland Medical CenterRisk of colonizationRibosomal RNA gene sequencingRNA gene sequencingAdmission swabCRPA infectionPseudomonas aeruginosaICU admissionPatient characteristicsMicrobiota disruptionMedical CenterGastrointestinal tractAdditional swabsAntimicrobial exposureLower riskEvaluated associationsPatientsProtective role