A 68-year-old man had recurrent bacteremia by carbapenemase (KPC)-producing resistant to ceftazidime-avibactam and cefiderocol. The sequencing of a target region showed that it harbored a KPC-3 variant enzyme (D179Y; KPC-31), which confers resistance to ceftazidime-avibactam and restores meropenem susceptibility. The patient was successfully treated with meropenem-vaborbactam.
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http://dx.doi.org/10.1093/ofid/ofab141 | DOI Listing |
Antibiotics (Basel)
December 2024
Microbiology Laboratory, Bicêtre University Hospital, AP-HP Paris Saclay University, 94270 Le Kremlin-Bicêtre, France.
Background: Meropenem-vaborbactam (MEM-VAB) is a novel carbapenem-beta-lactamase-inhibitor combination that demonstrates activity against carbapenem-resistant (CR) Gram-negative bacteria, and more specifically KPC-producers, since vaborbactam is an effective inhibitor of KPC enzymes in vitro. This study aimed to describe the initial uses and efficacy of MEM-VAB for compassionate treatment during the first 21 months following its early access in France.
Method: A national multicenter retrospective study was conducted, including all patients who received at least one dose of MEM-VAB between 20 July 2020, and 5 April 2022.
Expert Rev Anti Infect Ther
December 2024
Faculty of Medicine, Infectious Diseases and Clinical Microbiology, Hacettepe University, Ankara, Türkiye.
Open Forum Infect Dis
June 2021
Infectious Diseases Clinic, Department of Clinical and Experimental Medicine, Azienda Universitaria Ospedaliera Pisana, University of Pisa, Pisa, Italy.
A 68-year-old man had recurrent bacteremia by carbapenemase (KPC)-producing resistant to ceftazidime-avibactam and cefiderocol. The sequencing of a target region showed that it harbored a KPC-3 variant enzyme (D179Y; KPC-31), which confers resistance to ceftazidime-avibactam and restores meropenem susceptibility. The patient was successfully treated with meropenem-vaborbactam.
View Article and Find Full Text PDFJ Pediatric Infect Dis Soc
July 2019
Departments of Pharmacy, Johns Hopkins University School of Medicine, Baltimore, Maryland.
With the current carbapenem-resistant organism crisis, conventional approaches to optimizing pharmacokinetic-pharmacodynamic parameters are frequently inadequate, and traditional salvage agents (eg, colistin, tigecycline, etc) confer high toxicity and/or have low efficacy. However, several β-lactam agents with activity against carbapenem-resistant organisms were approved recently by the US Food and Drug Administration, and more are anticipated to be approved in the near future. The primary goal of this review is to assist infectious disease practitioners with preferentially selecting 1 agent over another when treating patients infected with a carbapenem-resistant organism.
View Article and Find Full Text PDFAntimicrob Agents Chemother
January 2019
Division of Infectious Disease and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
We report a case of a 24-year-old liver transplant recipient who developed hepatic artery thrombosis and graft failure, which was complicated by subphrenic abscess and persistent carbapenemase (KPC)-producing bacteremia. Ceftazidime-avibactam treatment led to emergence of resistance, and alternative combination therapy failed due to persistent infection and toxicity. The infection resolved after initiation of meropenem-vaborbactam, which created a bridge to retransplantation.
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