Details

Autor(en) / Beteiligte

• Zhen, Sisi
• Lin, Qingsong
• Chen, Zhangjie
• Shen, Yuyan
• Chen, Xin
• Pang, Aiming
• Yang, Donglin
• Zhang, Rongli
• Ma, Qiaoling
• He, Yi
• Wei, Jialin
• Zhai, Weihua
• Jiang, Erlie
• Han, Mingzhe
• Wang, Jianxiang
• Feng, Sizhou

Titel

Ceftazidime-avibactam in the treatment of bacteremia due to carbapenem-resistant gram-negative bacteria in hematological patients: Experience in a single center

Ist Teil von

• Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 2024-07, Vol.30 (7), p.608-615

Ort / Verlag

Netherlands: Elsevier Ltd

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Limited experience exists with ceftazidime-avibactam (CAZ-AVI) in treating bacteremia caused by carbapenem-resistant Enterobacterales (CRE) and Pseudomonas aeruginosa (CRPA) in hematological patients. We performed a single-center, retrospective, observational study including patients who received CAZ-AVI for bacteremia due to CRE or CRPA between 2018 and 2022. The primary outcome was 30-day survival. We conducted a multivariable analysis to identify predictors of survival. 56 patients were included and 57 (41 CRE and 16 CRPA) strains were isolated. 35 strains produced carbapenemase, including 25 metallo-beta-lactamase (MBL) and 10 serine-beta-lactamase. 48 patients (85.7 %) received combination therapy. All patients with MBL-CRE bacteremia (n = 24) received combination therapy with aztreonam (AZT). The susceptibility rates to CAZ-AVI were only 26.8 % (11/41) in CRE and 80.0 % (8/10) in CRPA. The 30-day survival rates were 85.0 % (34/40) in the CRE group and 81.3 % (13/16) in the CRPA group. In patients with MBL-CRE bacteremia, the 30-day survival was as high as 91.7 % (22/24) due to combination with AZT. Ceftazidime did not influence the activity of aztreonam-avibactam against MBL-CRE in-vitro. Multivariable cox analysis revealed neutropenia >14 days (P = 0.002, HR: 34.483, 95%CI: 3.846–333.333) and a higher Pitt bacteremia score (P = 0.005, HR: 2.074, 95%CI: 1.253–3.436) were risk factors for 30-day survival. CAZ-AVI is highly effective in treating bacteremia due to CRPA and serine-beta-lactamase CRE. The combination of avibactam with AZT is highly effective in treating bacteremia due to AZT-resistant MBL producers.