Clinical effectiveness of cefiderocol for the treatment of bloodstream infections due to carbapenem-resistant Acinetobacter baumannii during the COVID-19 era: a single center, observational study

European Journal of Clinical Microbiology & Infectious Diseases, Journal Year: 2024, Volume and Issue: 43(6), P. 1149 - 1160

Published: April 18, 2024

We assessed the clinical effectiveness of cefiderocol (CFDC) in comparison with colistin (COL) for treatment carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections (BSI).

Language: Английский

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Epidemiology, Mechanisms of Resistance and Treatment Algorithm for Infections Due to Carbapenem-Resistant Gram-Negative Bacteria: An Expert Panel Opinion

Antibiotics, Journal Year: 2022, Volume and Issue: 11(9), P. 1263 - 1263

Published: Sept. 17, 2022

Antimicrobial resistance represents a serious threat for global health, causing an unacceptable burden in terms of morbidity, mortality and healthcare costs. In particular, 2017, carbapenem-resistant organisms were listed by the WHO among group pathogens which novel treatment strategies are urgently needed. Fortunately, several drugs combinations have been introduced recent years to treat multi-drug-resistant (MDR) bacteria. However, correct use these molecules is needed preserve their efficacy. present paper, we will provide overview on epidemiology mechanisms most common MDR Gram-negative bacteria, proposing algorithm management infections due bacteria based clinical evidence.

Language: Английский

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Effect of ceftazidime/avibactam plus fosfomycin combination on 30 day mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae: results from a multicentre retrospective study

JAC-Antimicrobial Resistance, Journal Year: 2022, Volume and Issue: 4(6)

Published: Nov. 3, 2022

The primary outcome of the study was to evaluate effect on 30 day mortality combination ceftazidime/avibactam + fosfomycin in treatment bloodstream infections (BSIs) caused by KPC-producing Klebsiella pneumoniae (KPC-Kp).From October 2018 March 2021, a retrospective, two-centre performed patients with KPC-Kp BSI hospitalized at Sapienza University (Rome) and ISMETT-IRCCS (Palermo) treated ceftazidime/avibactam-containing regimens. A matched cohort (1:1) analysis performed. Cases were receiving controls alone or vitro non-active drugs different from (ceftazidime/avibactam ± other). Patients for age, Charlson comorbidity index, ward isolation (ICU non-ICU), source infection severity BSI, expressed as INCREMENT carbapenemase-producing Enterobacteriaceae (CPE) score.Overall, 221 included study. Following 1:1 match, 122 subjects retrieved: 61 cases fosfomycin) No difference overall emerged between controls, whereas had more non-BSI higher number deaths attributable secondary infections. Almost half prescribed without MIC availability. after stratification susceptibility availability dosage. SARS-CoV-2 ICS ≥ 8 independently predicted mortality, an appropriate definitive therapy protective.Our data show that used having its testing available. Although no found associated lower rate subsequent than other ceftazidime/avibactam-based

Language: Английский

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Salvage therapy with sulbactam/durlobactam against cefiderocol-resistant Acinetobacter baumannii in a critically ill burn patient: clinical challenges and molecular characterization

JAC-Antimicrobial Resistance, Journal Year: 2023, Volume and Issue: 5(3)

Published: May 3, 2023

Abstract Background Carbapenem-resistant Acinetobacter baumannii (CRAB) infections are associated with high mortality rates. The optimal treatment regimen for CRAB has not been defined. Cefiderocol recently introduced in the armamentarium against but there is concern about treatment-emergent resistance. Since rates remain high, further antibiotic options needed. Methods We report a case of severe infection by resistant to both colistin and cefiderocol treated sulbactam/durlobactam describe molecular features strain. Susceptibility was detected disc diffusion according EUCAST breakpoints. determined Etest preliminary breakpoints provided Entasis Therapeutics. Whole Genome Sequencing (WGS) isolate performed. Results A burn patient ventilator-associated pneumonia received as compassionate use. She alive after 30 days from end therapy. Complete microbiological eradication achieved. harboured blaADC-30, blaOXA-23 blaOXA-66. missense mutation PBP3 detected. TonB-dependent siderophore receptor gene piuA that showed frameshift causing premature stop codon (K384fs). Moreover, fepA gene, which orthologous pirA, interrupted transposon insertion P635-ISAba125 (IS30 family). Conclusions Further all available antibiotics urgently Sulbactam/durlobactam may be future option MDR A. baumannii.

Language: Английский

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CEFTO-CURE study: CEFTObiprole Clinical Use in Real-lifE – a multi-centre experience in Italy

International Journal of Antimicrobial Agents, Journal Year: 2023, Volume and Issue: 62(1), P. 106817 - 106817

Published: April 13, 2023

Ceftobiprole is approved in Europe for treatment of community-acquired pneumonia and non-ventilator-associated hospital-acquired (HAP) adults. Real-world data are limited.This multi-centre, observational, ambispective investigator-initiated study was undertaken Italy from January 2018 to December 2019 order evaluate the use ceftobiprole a real-world setting.Overall, 195 patients 10 centres were evaluated (68% retrospectively). Male sex prevalent (n=121, 62%). Median age 67 [interquartile range (IQR) 53-75] years. Charlson Comorbidity Index score 5 (IQR 3-7). The most common indication (151/195, 77%), especially HAP. Other uses skin soft tissue infections (5%), endocarditis (4%) bone (4%). usually an empiric choice (65%), combination with other drugs (66%) as second-line therapy (58%). A causative agent found 39% cases. diagnosis sepsis made 59 cases (30%). Success clinically evaluable population (excluding 12 due isolation pathogens outside ceftobiprole's spectrum activity) obtained 79% cases, all-cause mortality 20%. On multi-level analysis, three predictors positively associated clinical success: male gender, detection causal agent. Sepsis negative predictor. Nine factors independently associated, favourably or unfavourably, fatal outcome.Ceftobiprole safe effective therapeutic choice, even setting. More needed establish its efficacy sepsis.

Language: Английский

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Clinical Features and Outcomes of Infections Caused by Metallo-β-Lactamase–Producing Enterobacterales: A 3-Year Prospective Study From an Endemic Area

Clinical Infectious Diseases, Journal Year: 2023, Volume and Issue: 78(5), P. 1111 - 1119

Published: Nov. 30, 2023

Metallo-β-lactamase (MBL)-producing Enterobacterales are increasing worldwide. Our aim was to describe clinical features, treatments, and outcomes of infections by MBL-Enterobacterales.

Language: Английский

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Cefiderocol Efficacy in a Real-Life Setting: Single-Centre Retrospective Study

Antibiotics, Journal Year: 2023, Volume and Issue: 12(4), P. 746 - 746

Published: April 13, 2023

The current carbapenem-resistant gram-negative bacteria (CR-GN) treatment guidelines lack strong evidence about cefiderocol (CFD) efficacy against CR-GN, especially CRAB. study's purpose is to evaluate the effectiveness of CFD in a real-life setting. We made single-center retrospective study 41 patients who received our hospital for several CR-GN infections. Bloodstream infections (BSI) affected 43.9% (18/41) patients, while CRAB 75.6% (31/41) isolated patients. Thirty-days (30-D) all-causes mortality 36.6% (15/41) end-of-treatment (EOT) clinical cure 56.1% (23/41). Finally, microbiological eradication at EOT (23/41) Univariate and multivariate analysis showed that septic shock an independent factor associated with mortality. Subgroup analyses no difference between monotherapy combination therapy.

Language: Английский

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Severe infections caused by difficult-to-treat Gram-negative bacteria

Current Opinion in Critical Care, Journal Year: 2023, Volume and Issue: 29(5), P. 438 - 445

Published: July 31, 2023

Purpose of review Antimicrobial resistance (AMR) in Gram-negative bacteria (GNB) poses a significant global health concern, contributing to increased infections, mortality rates, and healthcare costs. This discusses the main clinical manifestations, therapeutic options, recent findings managing antibiotic-resistant GNB, with focus on difficult-to-treat infections. Recent Difficult-to-treat (DTR) is novel classification that identifies GNB exhibiting intermediate or resistant phenotypes first-line agents carbapenem, beta-lactam, fluoroquinolone categories. The pathogens implicated severe infections include DTR Enterobacterales, Pseudomonas aeruginosa , Acinetobacter baumannii. Although implications strains are still under investigation, certain studies have linked them prolonged hospital stays poor patient outcomes. Summary Severe caused by DTR-GNB pose formidable challenge for providers represent growing issue. proper administration optimization antibiotics at our disposal paramount importance combating bacterial improving prognosis.

Language: Английский

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Reduce susceptibility to cefiderocol in gram negative bacteria in children: Is hope already lost before it’s even arrived?

Journal of Infection and Public Health, Journal Year: 2024, Volume and Issue: 17(4), P. 624 - 631

Published: Feb. 12, 2024

In last years the diffusion of carbapenem resistance in Gram-negative bacteria (CR-GNB) is increasing worldwide, mainly due to expression carbapenemases. Cefiderocol has molecular characteristics that ideally confers activity against all CR-GNB, but resistant strains have already been identified. We describe cefiderocol susceptibility profile among multi-drug isolated from pediatric patients.

Language: Английский

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International guidelines for the treatment of carbapenem-resistant Gram-negative Bacilli infections: A comparison and evaluation

International Journal of Antimicrobial Agents, Journal Year: 2024, Volume and Issue: 63(5), P. 107120 - 107120

Published: Feb. 28, 2024

Language: Английский

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