Ceftolozane/Tazobactam for Treatment of Severe ESBL-Producing
CRRT
ESBL
Enterobacterales
ceftolozane/tazobactam
septic shock
Journal
Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
07
02
2020
accepted:
17
04
2020
entrez:
29
5
2020
pubmed:
29
5
2020
medline:
29
5
2020
Statut:
epublish
Résumé
Few data are reported in the literature about the outcome of patients with severe extended-spectrum β-lactamase-producing A multicenter retrospective study was performed in Italy (June 2016-June 2019). Successful clinical outcome was defined as complete resolution of clinical signs/symptoms related to ESBL-E infection and lack of microbiological evidence of infection. The primary end point was to identify predictors of clinical failure of C/T therapy. C/T treatment was documented in 153 patients: pneumonia was the most common diagnosis (n = 46, 30%), followed by 34 cases of complicated urinary tract infections (22.2%). Septic shock was observed in 42 (27.5%) patients. C/T was used as empiric therapy in 46 (30%) patients and as monotherapy in 127 (83%) patients. Favorable clinical outcome was observed in 128 (83.7%) patients; 25 patients were considered to have failed C/T therapy. Overall, 30-day mortality was reported for 15 (9.8%) patients. At multivariate analysis, Charlson comorbidity index >4 (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.9-3.5; Data show that C/T could be a valid option in empiric and/or targeted therapy in patients with severe infections caused by ESBL-producing
Sections du résumé
BACKGROUND
BACKGROUND
Few data are reported in the literature about the outcome of patients with severe extended-spectrum β-lactamase-producing
METHODS
METHODS
A multicenter retrospective study was performed in Italy (June 2016-June 2019). Successful clinical outcome was defined as complete resolution of clinical signs/symptoms related to ESBL-E infection and lack of microbiological evidence of infection. The primary end point was to identify predictors of clinical failure of C/T therapy.
RESULTS
RESULTS
C/T treatment was documented in 153 patients: pneumonia was the most common diagnosis (n = 46, 30%), followed by 34 cases of complicated urinary tract infections (22.2%). Septic shock was observed in 42 (27.5%) patients. C/T was used as empiric therapy in 46 (30%) patients and as monotherapy in 127 (83%) patients. Favorable clinical outcome was observed in 128 (83.7%) patients; 25 patients were considered to have failed C/T therapy. Overall, 30-day mortality was reported for 15 (9.8%) patients. At multivariate analysis, Charlson comorbidity index >4 (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.9-3.5;
CONCLUSIONS
CONCLUSIONS
Data show that C/T could be a valid option in empiric and/or targeted therapy in patients with severe infections caused by ESBL-producing
Identifiants
pubmed: 32462046
doi: 10.1093/ofid/ofaa139
pii: ofaa139
pmc: PMC7237821
doi:
Types de publication
Journal Article
Langues
eng
Pagination
ofaa139Investigateurs
Matteo Bassetti
(M)
Antonio Vena
(A)
Daniele Roberto Giacobbe
(DR)
Claudio Viscoli
(C)
Alessandro Russo
(A)
Marco Falcone
(M)
Giusy Tiseo
(G)
Francesco Menichetti
(F)
Stefano Verdenelli
(S)
Silvia Fabiani
(S)
Nadia Castaldo
(N)
Davide Pecori
(D)
Alessia Carnellutti
(A)
Filippo Givone
(F)
Elena Graziano
(E)
Maria Merelli
(M)
Barbara Cadeo
(B)
Maddalena Peghin
(M)
Maddalena Giannella
(M)
Renato Pascale
(R)
Pierlugi Viale
(P)
Annamaria Cattelan
(A)
Ludovica Cipriani
(L)
Davide Coletto
(D)
Cristina Mussini
(C)
Margherita Digaetano
(M)
Carlo Tascini
(C)
Novella Carannante
(N)
Claudio Maria Mastroianni
(CM)
Russo Gianluca
(R)
Alessandra Oliva
(A)
Maria Rosa Ciardi
(MR)
Camilla Ajassa
(C)
Tiziana Tieghi
(T)
Mario Tumbarello
(M)
Angela Raffaella Losito
(AR)
Francesca Raffaelli
(F)
Paolo Grossi
(P)
Cristina Rovelli
(C)
Stefania Artioli
(S)
Giorgia Caruana
(G)
Roberto Luzzati
(R)
Giulia Bontempo
(G)
Nicola Petrosillo
(N)
Alessandro Capone
(A)
Giuliano Rizzardini
(G)
Massimo Coen
(M)
Matteo Passerini
(M)
Antonio Mastroianni
(A)
Giuliana Guadagnino
(G)
Filippo Urso
(F)
Guglielmo Borgia
(G)
Ivan Gentile
(I)
Alberto Enrico Maraolo
(AE)
Massimo Crapis
(M)
Sergio Venturini
(S)
Giustino Parruti
(G)
Francesca Trave
(F)
Gioacchino Angarano
(G)
Sergio Carbonara
(S)
Michele Fabiano Mariani
(MF)
Massimo Girardis
(M)
Antonio Cascio
(A)
Claudia Gioe
(C)
Marco Anselmo
(M)
Emanuele Malfatto
(E)
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
Références
JAMA. 2016 Feb 23;315(8):801-10
pubmed: 26903338
Lancet. 2015 May 16;385(9981):1949-56
pubmed: 25931244
Int J Antimicrob Agents. 2018 Mar;51(3):443-449
pubmed: 29180280
Clin Microbiol Infect. 2014 Dec;20(12):1357-62
pubmed: 24980276
Clin Infect Dis. 2015 May 15;60(10):1462-71
pubmed: 25670823
Antimicrob Agents Chemother. 2005 Feb;49(2):760-6
pubmed: 15673761
Clin Infect Dis. 2017 Jul 1;65(1):158-161
pubmed: 28329350
JAMA. 2018 Sep 11;320(10):984-994
pubmed: 30208454
Int J Antimicrob Agents. 2019 Apr;53(4):408-415
pubmed: 30415002
J Antimicrob Chemother. 2004 Jul;54(1):134-8
pubmed: 15150168
Lancet. 2000 Oct 7;356(9237):1255-9
pubmed: 11072960
J Antimicrob Chemother. 2017 Jan;72(1):268-272
pubmed: 27707990
Pharmacotherapy. 2016 May;36(5):e30-e33
pubmed: 27012450
Antimicrob Agents Chemother. 2007 Jun;51(6):1987-94
pubmed: 17387156
Clin Infect Dis. 2006 Dec 1;43(11):1407-14
pubmed: 17083012
Int J Antimicrob Agents. 2018 Nov;52(5):577-585
pubmed: 29969692
Clin Infect Dis. 2017 Jul 1;65(1):110-120
pubmed: 29017262
Clin Infect Dis. 2015 May 1;60(9):1319-25
pubmed: 25586681
Lancet Infect Dis. 2008 Mar;8(3):159-66
pubmed: 18291338
Expert Rev Anti Infect Ther. 2018 Apr;16(4):307-320
pubmed: 29493397
Clin Microbiol Rev. 2005 Oct;18(4):657-86
pubmed: 16223952
J Antimicrob Chemother. 2017 May 1;72(5):1386-1395
pubmed: 28165526
Int J Antimicrob Agents. 2017 May;49(5):624-630
pubmed: 28286115
Lancet Infect Dis. 2019 Dec;19(12):1299-1311
pubmed: 31563344
Int J Antimicrob Agents. 2016 Sep;48(3):342-3
pubmed: 27451086
Int J Antimicrob Agents. 2016 Dec;48(6):748-752
pubmed: 27838278