Juan J Castón1, Isabel Lacort-Peralta2, Pilar Martín-Dávila3, Belén Loeches4, Salvador Tabares5, Liz Temkin6, Julián Torre-Cisneros7, José R Paño-Pardo8. 1. Infectious Diseases Unit Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain. 2. Pediatric and Specialties Unit, Hospital Universitario Reina Sofía, Córdoba, Spain. 3. Infectious Diseases Service, Hospital Ramón y Cajal, Madrid, Spain. 4. Infectious Diseases and Clinical Microbiology Unit, Hospital Universitario La Paz-IDIPAZ, Madrid, Spain. 5. Departament of Hematology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain. 6. Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 7. Infectious Diseases Unit Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain. Electronic address: julian.torre.sspa@juntadeandalucia.es. 8. Infectious Diseases and Clinical Microbiology Unit, Hospital Universitario La Paz-IDIPAZ, Madrid, Spain; Present address: Division of Infectious Diseases Hospital Clínico Universitario "Lozano Blesa"-IIS Aragón, Zaragoza, Spain.
Abstract
OBJECTIVES: The primary objective was to describe clinical features, treatment and outcomes in patients with carbapenemase-producing Enterobacteriaceae (CPE) bacteremia. Additionally, patients treated with ceftazidime/avibactam (study group) were compared to the rest of the patients (comparator group) to determine the influence of the treatment in both crude mortality and clinical cure. METHODS: Multicenter and retrospective study that included patients with hematologic malignancies who had CPE bacteremia. A bivariate analysis was performed to compare the clinical variables between the study group and the control group. RESULTS: 31 patients were included. Bacteremia was considered primary in 14 (45%) patients. Overall crude mortality at 30days was 45.2% (n=14). Mortality was more frequent when septic shock (78.6% vs 11.8%; p>0.001) and higher Pitt score (6+14 vs 1.5+4; p<0.01) were present. 8 patients (25.8%) received treatment with ceftazidime/avibactam. No significant differences in crude mortality were found between study and comparator groups (p=0.19). In contrast, patients in study group had higher clinical cure rates than the comparator group within 14days of initiating treatment (85.7% vs. 34.8%, respectively, p=0.031). CONCLUSIONS: CPE bacteremia is associated with high mortality in patients with hematologic malignancies. Ceftazidime/avibactam may be an effective alternative for treating these patients.
OBJECTIVES: The primary objective was to describe clinical features, treatment and outcomes in patients with carbapenemase-producing Enterobacteriaceae (CPE) bacteremia. Additionally, patients treated with ceftazidime/avibactam (study group) were compared to the rest of the patients (comparator group) to determine the influence of the treatment in both crude mortality and clinical cure. METHODS: Multicenter and retrospective study that included patients with hematologic malignancies who had CPE bacteremia. A bivariate analysis was performed to compare the clinical variables between the study group and the control group. RESULTS: 31 patients were included. Bacteremia was considered primary in 14 (45%) patients. Overall crude mortality at 30days was 45.2% (n=14). Mortality was more frequent when septic shock (78.6% vs 11.8%; p>0.001) and higher Pitt score (6+14 vs 1.5+4; p<0.01) were present. 8 patients (25.8%) received treatment with ceftazidime/avibactam. No significant differences in crude mortality were found between study and comparator groups (p=0.19). In contrast, patients in study group had higher clinical cure rates than the comparator group within 14days of initiating treatment (85.7% vs. 34.8%, respectively, p=0.031). CONCLUSIONS:CPE bacteremia is associated with high mortality in patients with hematologic malignancies. Ceftazidime/avibactam may be an effective alternative for treating these patients.
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