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Combination Therapy with Aminoglycoside in Bacteremiasdue to ESBL-Producing Enterobacteriaceae in ICU.
Benetazzo, Lucie; Delannoy, Pierre-Yves; Houard, Marion; Wallet, Frederic; Lambiotte, Fabien; Vachée, Anne; Batt, Christian; Van Grunderbeeck, Nicolas; Nseir, Saad; Robineau, Olivier; Meybeck, Agnès.
Afiliação
  • Benetazzo L; Service de Réanimation et Maladies Infectieuses, Centre Hospitalier de Tourcoing, 135 Rue du Président Coty, 59200 Tourcoing, France.
  • Delannoy PY; Service de Réanimation et Maladies Infectieuses, Centre Hospitalier de Tourcoing, 135 Rue du Président Coty, 59200 Tourcoing, France.
  • Houard M; Service de RéanimationMédicale, CHRU de Lille, 2 Avenue Oscar Lambret, 59000 Lille, France.
  • Wallet F; Laboratoire de Microbiologie, CHRU de Lille, 2 Avenue Oscar Lambret, 59000 Lille, France.
  • Lambiotte F; Service de Réanimation, Centre Hospitalier de Valenciennes, 114 Avenue Desandrouin, 59300 Valenciennes, France.
  • Vachée A; Laboratoire de Microbiologie, Centre Hospitalier de Roubaix, 11 Boulevard Lacordaire, 59100 Roubaix, France.
  • Batt C; Service de Réanimation, Centre Hospitalier de Dunkerque, Avenue Louis Herbeaux, 59240 Dunkerque, France.
  • Van Grunderbeeck N; Service de Réanimation, Centre Hospitalier de Lens, 99 Route de la Bassée, 62300 Lens, France.
  • Nseir S; Service de RéanimationMédicale, CHRU de Lille, 2 Avenue Oscar Lambret, 59000 Lille, France.
  • Robineau O; Service des Maladies Infectieuses et du Voyageur, Centre Hospitalier de Tourcoing, 135 Rue du Président Coty, 59200 Tourcoing, France.
  • Meybeck A; Service des Maladies Infectieuses et du Voyageur, Centre Hospitalier de Tourcoing, 135 Rue du Président Coty, 59200 Tourcoing, France.
Antibiotics (Basel) ; 9(11)2020 Nov 04.
Article em En | MEDLINE | ID: mdl-33158238
OBJECTIVES: Evaluation of the efficacy of empirical aminoglycoside in critically ill patients with bloodstream infections caused by extended-spectrum ß-lactamase producing Enterobacteriaceae (ESBL-E BSI). METHODS: Patients treated between 2011 and 2018 for ESBL-E BSI in the ICU of six French hospitals were included in a retrospective observational cohort study. The primary endpoint was mortality on day 30. RESULTS: Among 307 patients, 169 (55%) were treated with empirical aminoglycoside. Death rate was 40% (43% with vs. 39% without aminoglycoside, p = 0.55). Factors independently associated with death were age ≥70 years (OR: 2.67; 95% CI: 1.09-6.54, p = 0.03), history of transplantation (OR 5.2; 95% CI: 1.4-19.35, p = 0.01), hospital acquired infection (OR 8.67; 95% CI: 1.74-43.08, p = 0.008), vasoactive drugs >48 h after BSI onset (OR 3.61; 95% CI: 1.62-8.02, p = 0.001), occurrence of acute respiratory distress syndrome (OR 2.42; 95% CI: 1.14-5.16, p = 0.02), or acute renal failure (OR 2.49; 95% CI: 1.14-5.47, p = 0.02). Antibiotherapy appropriateness was more frequent in the aminoglycoside group (91.7% vs. 77%, p = 0.001). Rate of renal impairment was similar in both groups (21% vs. 24%, p = 0.59). CONCLUSIONS: In intensive care unit (ICU) patients with ESBL-E BSI, empirical treatment with aminoglycoside was frequent. It demonstrated no impact on mortality, despite increasing treatment appropriateness.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Risk_factors_studies Idioma: En Revista: Antibiotics (Basel) Ano de publicação: 2020 Tipo de documento: Article País de afiliação: França

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Risk_factors_studies Idioma: En Revista: Antibiotics (Basel) Ano de publicação: 2020 Tipo de documento: Article País de afiliação: França