Mortality Attributable to Bloodstream Infections Caused by Different Carbapenem-Resistant Gram-Negative Bacilli: Results From a Nationwide Study in Italy (ALARICO Network)

Clinical Infectious Diseases, Journal Year: 2023, Volume and Issue: 76(12), P. 2059 - 2069

Published: Feb. 19, 2023

Our aim was to analyze mortality attributable carbapenem-resistant (CR) gram-negative bacilli (GNB) in patients with bloodstream infections (BSIs).Prospective multicentric study including GNB-BSI from 19 Italian hospitals (June 2018-January 2020). Patients were followed-up 30 days. Primary outcomes 30-day and mortality. Attributable calculated the following groups: Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacterales, metallo-β-lactamases (MBL)-producing CR-Pseudomonas aeruginosa (CRPA), CR-Acinetobacter baumannii (CRAB). A multivariable analysis hospital fixed-effect built identify factors associated Adjusted OR (aORs) reported. according DRIVE-AB Consortium.Overall, 1276 monomicrobial GNB BSI included: 723/1276 (56.7%) carbapenem-susceptible (CS)-GNB, 304/1276 (23.8%) KPC-, 77/1276 (6%) MBL-producing CRE, 61/1276 (4.8%) CRPA, 111/1276 (8.7%) CRAB BSI. Thirty-day CS-GNB 13.7% compared 26.6%, 36.4%, 32.8% 43.2% by KPC-CRE, MBL-CRE, CRPA CRAB, respectively (P < .001). On analysis, age, ward of hospitalization, SOFA score, Charlson Index mortality, while urinary source infection early appropriate therapy resulted protective factors. Compared CS-GNB, CRE (aOR 5.86, 95% CI 2.72-12.76), 1.99, 1.48-5.95) 2.65, 1.52-4.61) significantly rates 5% for 35% MBL, 19% 16% CRAB.In BSIs, carbapenem-resistance is an excess carrying highest risk death.

Language: Английский

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Acinetobacter baumannii in the critically ill: complex infections get complicated

Frontiers in Microbiology, Journal Year: 2023, Volume and Issue: 14

Published: June 22, 2023

is increasingly associated with various epidemics, representing a serious concern due to the broad level of antimicrobial resistance and clinical manifestations. During last decades,

Language: Английский

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Carbapenem-resistant Acinetobacter baumannii: A challenge in the intensive care unit

Frontiers in Microbiology, Journal Year: 2022, Volume and Issue: 13

Published: Nov. 10, 2022

Carbapenem-resistant Acinetobacter baumannii (CRAB) has become one of the leading causes healthcare-associated infections globally, particularly in intensive care units (ICUs). Cross-transmission microorganisms between patients and hospital environment may play a crucial role ICU-acquired CRAB colonization infection. The control treatment infection ICUs have been recognized as global challenge because its multiple-drug resistance. main concern is that can be disastrous for ICU if currently existing limited therapeutic alternatives fail future. Therefore, colonization, infection, transmission, resistance mechanisms need to systematically studied. To provide basis prevention countermeasures ICUs, we present an overview research on summarize clinical environmental reservoirs, discuss drug mechanism homology evaluate contemporary strategies.

Language: Английский

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New Antibiotics for Staphylococcus aureus Infection: An Update from the World Association of Infectious Diseases and Immunological Disorders (WAidid) and the Italian Society of Anti-Infective Therapy (SITA)

Antibiotics, Journal Year: 2023, Volume and Issue: 12(4), P. 742 - 742

Published: April 12, 2023

Staphylococcus aureus is an extremely virulent pathogen that capable of quickly evolving and developing antibiotic resistance. To overcome this problem, new antibiotics have been developed. Some these licenced for use in clinical practice, mainly the treatment adults with acute skin soft tissue infections, addition to both community-acquired pneumonia (CAP) nosocomial (hospital-acquired bacterial ventilator-associated pneumonia). In paper, main characteristics anti-staphylococcal drugs discussed. vitro studies demonstrated some better antimicrobial activity and, at least certain cases, more favourable pharmacokinetic properties higher safety tolerability than presently available drugs. This suggests they may a potential reducing risk failure S. therapy. However, in-depth analysis microbiological carried out seems indicate further need be conducted before problem resistance today can completely solved. Considering overall research, are active against appear present great therapeutic opportunity overcoming traditional There advantages reduce hospital stays economic costs associated their use.

Language: Английский

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A comprehensive review on medicinal plant extracts as antibacterial agents: Factors, mechanism insights and future prospects

Scientific African, Journal Year: 2024, Volume and Issue: 26, P. e02395 - e02395

Published: Sept. 28, 2024

Language: Английский

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A Four-Year Study of Antibiotic Resistance, Prevalence and Biofilm-Forming Ability of Uropathogens Isolated from Community- and Hospital-Acquired Urinary Tract Infections in Southern Italy

Pathogens, Journal Year: 2025, Volume and Issue: 14(1), P. 59 - 59

Published: Jan. 11, 2025

The aim of this study was to investigate the differences between nosocomial and community microorganisms isolated from patients with UTI by determining their bacterial profile, antibiotic resistance ability produce biofilms. A retrospective study, based on isolates consecutive urine samples collected January 2019 December 2023, conducted at a university hospital. main pathogens both hospital were same, but frequency isolation differed. Compared community-associated cases, hospital-associated infections have more Acinetobacter baumanii complex. In contrast, Proteus mirabilis prevalent in than infections. isolates, gram-positive bacteria showed lower overall antimicrobial (22%) compared gram-negative (30%). data demonstrated that individual strains exhibited disparate degrees capacity for biofilm formation. Additionally, indicate an inverse correlation production resistance. Isolates capacities comparison (29% 35%, respectively). Area-specific surveillance studies can provide valuable information patterns, which be useful guiding empirical treatment.

Language: Английский

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Current role of ceftobiprole in the treatment of hospital-acquired and community-acquired pneumonia: Expert opinion based on literature and real-life experiences

Expert Review of Anti-infective Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 30, 2025

Community-acquired pneumonia (CAP) and hospital-acquired (HAP) are major global health challenges, with high morbidity mortality rates. The increasing prevalence of multidrug-resistant (MDR) bacteria may diminish the effectiveness standard empirical antibiotics, highlighting need for broader-spectrum agents that target also MDR organisms. This review summarizes findings from a PubMed search on use ceftobiprole in CAP HAP. It highlights key features ceftobiprole, including its mechanism action broad spectrum activity against multiple pathogens. Clinical data randomized controlled trials real-world studies underscore non-inferiority to treatments, favorable safety profile clinical cure rates even challenging cases. Ceftobiprole represents valid option patients Its main advantages include activity, making it valuable therapeutic choice treating polymicrobial infections, profile, which makes good candidate elderly comorbidities polypharmacy. Caution is advised at risk ESBL-producing organisms or Pseudomonas aeruginosa where combination therapy recommended. Moreover, drug monitoring recommended improve outcomes, particularly complex conditions.

Language: Английский

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Real-World Use, Effectiveness, and Safety of Intravenous Fosfomycin: The FORTRESS Study

Infectious Diseases and Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: March 19, 2025

Intravenous fosfomycin (FOS) is a broad-spectrum antibiotic primarily used in combination therapy to treat severe infections caused by both Gram-positive (GP) and Gram-negative (GN) pathogens, including multi-drug resistant (MDR) bacteria. The aim of this study, the largest date, was evaluate effectiveness, safety, usage patterns, patient characteristics FOS real-world setting. Interim analysis an ongoing, prospective, non-interventional, multicentre study five European countries, involving centres Germany, Italy, United Kingdom, Greece, Austria. A total 716 patients were enrolled between January 2017 November 2023 (mean age: 62.8 years, APACHE II: 18.3, SOFA: 6.7). Main indications for bacteraemia/sepsis (23.6%), complicated urinary tract (18.0%), bone joint (17.4%). Other included hospital-acquired/ventilator-associated pneumonia (11.0%), skin soft tissue (9.1%), bacterial meningitis/central nervous system (CNS) (7.8%), infective endocarditis (6.4%). Most common pathogens identified Staphylococcus aureus (31.4%, methicillin-resistant S. aureus), Klebsiella spp. (including K. pneumoniae) (17.2%), Escherichia coli (14.2%), coagulase-negative staphylococci (12.9%), other Enterobacterales (10.9%), Pseudomonas aeruginosa (8.4%). In 34.6% patients, MDR pathogen involved. Carbapenem resistance (CR) high (59/123, 48.0%). most (90.2%). median dose 15 g/day. Overall, clinical success response favourable with 75.3% 83.4% at end treatment. Clinical rates or CR 78.0% 81.8%, respectively. Microbiological cure achieved 82.4% all patients. Electrolyte imbalances frequently observed adverse drug reactions, while gastrointestinal disorders rare. results from suggest that safe effective option as partner treatment GP GN deep-seated and/or involvement ClinicalTrials.gov identifier, NCT02979951.

Language: Английский

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Intravenous fosfomycin for treatment of severe infections caused by carbapenem-resistant Acinetobacter baumannii: a multicenter clinical experience

International Journal of Antimicrobial Agents, Journal Year: 2024, Volume and Issue: 64(1), P. 107190 - 107190

Published: April 30, 2024

Language: Английский

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Real-world experience with meropenem/vaborbactam for the treatment of infections caused by ESBL-producing Enterobacterales and carbapenem-resistant Klebsiella pneumoniae

European Journal of Clinical Microbiology & Infectious Diseases, Journal Year: 2024, Volume and Issue: unknown

Published: Feb. 20, 2024

Abstract Purpose Real-world experience with meropenem/vaborbactam (M/V) is limited. Our aim to report a clinical of M/V in the treatment resistant Gram-negative bacilli. Methods This prospective observational study including patients hospitalized University Hospital Pisa (March 2021–Jan 2023) infections by both extended-spectrum β-lactamases (ESBL)-producing Enterobacterales and carbapenem-resistant Klebsiella pneumoniae (Kp) treated M/V. The primary outcome measure was success, defined as composite survival, resolution signs symptoms absence microbiological failure at day 30 from infection onset. A multivariable regression analysis performed identify factors associated failure. Odds ratio (OR) 95% confidence intervals (CI) calculated. Results total 104 who received were included: 24/104 (23.1%) caused ESBL non-hypervirulent Enterobacterales, 17/104 (16.3%) ESBL-producing hypervirulent (hvKp) 63/104 (60.6%) CRE. most common bloodstream infections, followed urinary tract hospital-acquired pneumonia, intra-abdominal others. Septic shock occurred 16/104 (15.4%) patients. Clinical success achieved 77% patients, 30-day mortality rate 15.4%. In KPC-producing Kp rates 82% 11.5%, respectively. On analysis, SOFA score (OR 1.32, CI 1.02–1.7, p =0.032) independently failure, while source control 0.16, 0.03–0.89, =0.036) protective. Conclusions promising therapeutic option against difficult-to-treat CR-Kp.

Language: Английский

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