RESUMEN
Therapeutic options for bacteremia caused by carbapenem-resistant Enterobacterales (CRE) OXA-48-type are limited. The objective of this study was to analyze clinical success of CAZ-AVI compared with best available therapy (BAT) in patients with Klebsiella pneumoniae carbapenemase-producing OXA-48-type bacteremia (CRKp-OXA-48). We conducted a retrospective, single-center observational study in adult patients with CRKp-OXA-48 between December 2015 and May 2019. We collected the patients' clinical and epidemiological characteristics, antibiotic treatment (CAZ-AVI vs. BAT), and evolution. Factors associated with clinical success were analyzed using binary logistic regression. The study included 76 patients with CRKp-OXA-48-type bacteremia 33 received CAZ-AVI and 43 BAT. CAZ-AVI was mainly used in monotherapy (91%). Clinical success was more common in patients < 70-year-old (OR 4.79, 95% CI [1.435-16.002], p = 0.011) and CAZ-AVI treatment (OR 6.69, 95% CI [1.68-26.604], p = 0.007). Kaplan-Meier survival curve of 14-day mortality showed a lower mortality in patients who received CAZ-AVI (log rank 0.013). However, CAZ-AVI did not achieve statistical difference in IPTW for 14- and 30-day mortality (aOR 0.1, 95% CI [0.02-1.22], p = 0.076 and aOR 1.7, 95% CI [0.48-5.98], p = 0.413, respectively). CAZ-AVI treatment might be associated with a greater clinical success in CRKp-OXA-48 bacteremia.
Asunto(s)
Bacteriemia , Enterobacteriaceae Resistentes a los Carbapenémicos , Adulto , Anciano , Antibacterianos/uso terapéutico , Compuestos de Azabiciclo , Bacteriemia/tratamiento farmacológico , Proteínas Bacterianas , Ceftazidima/uso terapéutico , Cefalosporinas , Combinación de Medicamentos , Humanos , Klebsiella pneumoniae , Pruebas de Sensibilidad Microbiana , Estudios Retrospectivos , beta-LactamasasAsunto(s)
Antivirales/uso terapéutico , Hepatitis C Crónica/complicaciones , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/uso terapéutico , Interferones/uso terapéutico , Metilprednisolona/uso terapéutico , Polietilenglicoles/uso terapéutico , Ribavirina/uso terapéutico , Sarcoidosis Pulmonar/complicaciones , Sarcoidosis Pulmonar/tratamiento farmacológico , Adulto , Antivirales/administración & dosificación , Estudios de Seguimiento , Humanos , Interferón alfa-2 , Interferón-alfa/administración & dosificación , Masculino , Metilprednisolona/administración & dosificación , Polietilenglicoles/administración & dosificación , Proteínas Recombinantes , Ribavirina/administración & dosificación , Factores de Tiempo , Resultado del TratamientoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adulto , Dolor Abdominal/etiología , Carcinoma Hepatocelular/complicaciones , Carcinoma Hepatocelular , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/diagnósticoRESUMEN
No disponible