Ana Madueño1, Jonathan González-García2, María Del Mar Alonso Socas3, María Antonia Miguel Gómez4, María Lecuona5. 1. Servicio de Microbiología y Control de la Infección, Complejo Hospitalario Universitario de Canarias, La Laguna (Santa Cruz de Tenerife), España. Electronic address: ana_madueno@hotmail.com. 2. Servicio de Farmacia, Complejo Hospitalario Universitario de Canarias, La Laguna (Santa Cruz de Tenerife), España. 3. Sección de Enfermedades Infecciosas, Servicio de Medicina Interna, Complejo Hospitalario Universitario de Canarias, La Laguna (Santa Cruz de Tenerife), España. 4. Servicio de Microbiología y Control de la Infección, Complejo Hospitalario Universitario de Canarias, La Laguna (Santa Cruz de Tenerife), España. 5. Servicio de Microbiología y Control de la Infección, Complejo Hospitalario Universitario de Canarias, La Laguna (Santa Cruz de Tenerife), España; Departamento de Medicina Preventiva y Salud Pública, Universidad de La Laguna, La Laguna (Santa Cruz de Tenerife), España.
Abstract
INTRODUCTION: Limited therapeutic options and high mortality make the management of OXA-48-like carbapenemase-producing Klebsiella pneumoniae (KPOXA-48) bacteraemia complicated. The aim of the study was to describe the clinical characteristics of KPOXA-48 bacteraemia between October 2013 and December 2016. MATERIAL AND METHODS: The variables to analyse were retrospectively collected from medical records. Carbapenemase production was confirmed by phenotypic and molecular methods. RESULTS: A total of 38 patients with bacteraemia were included, mainly classified as hospital-acquired (n=31). The majority of cases were secondary bacteraemia (n=26), most commonly arising from the urinary tract (n=11). All isolates presented a multidrug-resistant profile with the extended spectrum beta-lactamase CTX-M-15 and the carbapenemase OXA-48-like production. The crude mortality rate with adequate targeted antibiotic therapy was 0%, rising to 55% with inadequate treatment (p=0.0015). CONCLUSIONS: This study highlights the importance of identifying this resistance mechanism, the patient factors, type of bacteraemia and adequacy of antibiotic therapy in the outcome of bacteraemia.
INTRODUCTION: Limited therapeutic options and high mortality make the management of OXA-48-like carbapenemase-producing Klebsiella pneumoniae (KPOXA-48) bacteraemia complicated. The aim of the study was to describe the clinical characteristics of KPOXA-48 bacteraemia between October 2013 and December 2016. MATERIAL AND METHODS: The variables to analyse were retrospectively collected from medical records. Carbapenemase production was confirmed by phenotypic and molecular methods. RESULTS: A total of 38 patients with bacteraemia were included, mainly classified as hospital-acquired (n=31). The majority of cases were secondary bacteraemia (n=26), most commonly arising from the urinary tract (n=11). All isolates presented a multidrug-resistant profile with the extended spectrum beta-lactamase CTX-M-15 and the carbapenemase OXA-48-like production. The crude mortality rate with adequate targeted antibiotic therapy was 0%, rising to 55% with inadequate treatment (p=0.0015). CONCLUSIONS: This study highlights the importance of identifying this resistance mechanism, the patient factors, type of bacteraemia and adequacy of antibiotic therapy in the outcome of bacteraemia.
Authors: Ekaterina S Kuzina; Tatiana S Novikova; Evgeny I Astashkin; Galina N Fedyukina; Angelina A Kislichkina; Natalia V Kurdyumova; Ivan A Savin; Olga N Ershova; Nadezhda K Fursova Journal: Antibiotics (Basel) Date: 2022-07-03