Background: Carbapenem-resistant Klebsiella pneumoniae bloodstream infections (CRKP BSI) are associated with high mortality rates and limited treatment options. This study compared the outcomes between ceftazidime-avibactam and carbapenem-based regimens in patients with nosocomial CRKP BSI.
Methods: This is a single-center, retrospective, observational study that analyzed adult patients with nosocomial CRKP BSI from January 2018 to December 2023. Patients were divided into ceftazidime-avibactam (n = 47) and carbapenem-based regimen (n = 54) groups. Primary outcomes included 7-, 14-, 21-, and 28-day mortality rates, microbiological cure rates, and length of hospital stay. Multivariate analysis was performed to identify factors associated with mortality.
Results: The ceftazidime-avibactam group showed significantly lower 7-day mortality (8.51 % vs. 25.93 %, p = 0.043) and higher survival rates in Kaplan-Meier analysis (p = 0.021). Multivariate analysis revealed that ceftazidime-avibactam significantly reduced 7-day mortality (adjusted hazard ratio: 0.182, 95 % CI: 0.050-0.660, p = 0.010). Leukemia significantly increased both 7-day and all-cause mortality. Elevated white blood cell counts, and C-reactive protein levels were associated with increased mortality risk.
Conclusion: Ceftazidime-avibactam demonstrated superior short-term survival benefits compared to carbapenem-based regimens in treating nosocomial CRKP BSI. However, long-term outcomes were more influenced by underlying conditions and inflammatory status.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jmii.2025.03.003 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effectiveness comparison between ceftazidime-avibactam and carbapenem-based regimens in nosocomial carbapenem-resistant Klebsiella pneumoniae bloodstream infections.
J Microbiol Immunol Infect
March 2025
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; Center for Infection Control, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. Electronic address:
Background: Carbapenem-resistant Klebsiella pneumoniae bloodstream infections (CRKP BSI) are associated with high mortality rates and limited treatment options. This study compared the outcomes between ceftazidime-avibactam and carbapenem-based regimens in patients with nosocomial CRKP BSI.
Methods: This is a single-center, retrospective, observational study that analyzed adult patients with nosocomial CRKP BSI from January 2018 to December 2023.
Infections and treatment modalities in pediatric victims of the Kahramanmaraş/Türkiye earthquake.
Pediatr Int
November 2024
Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Türkiye.
Background: Data on infections in children are scarce in the context of earthquakes. Here, we describe our clinical experiences regarding infections in pediatric victims after the earthquakes in Kahramanmaraş/Türkiye.
Methods: Trauma patients after the Kahramanmaraş earthquakes, aged under 18 years and admitted to our hospital, were evaluated retrospectively.
Analysis of risk factors and different treatments for infections caused by carbapenem-resistant Acinetobacter baumannii in Shaanxi, China.
BMC Infect Dis
October 2024
Department of Clinical Laboratory, Hanzhong Central Hospital, 22 Kangfu Road, Hanzhong, Shaanxi, People's Republic of China.
Article Synopsis
- Carbapenem-resistant Acinetobacter baumannii (CRAB) infections have become a significant global concern, with increasing resistance rates, prompting a study of 110 infected patients to analyze risk factors and treatment effectiveness.
- Poor prognosis was observed in 43.6% of CRAB patients, with mechanical ventilation and puncture identified as major risk factors for infection.
- Among those treated for CRAB, combination antimicrobial therapy showed better outcomes in comparison to monotherapy, and specific strain types were linked to higher mortality rates.
The Distribution of Multidrug-resistant Microorganisms and Treatment Status of Hospital-acquired Pneumonia/Ventilator-associated Pneumonia in Adult Intensive Care Units: a Prospective Cohort Observational Study.
J Korean Med Sci
October 2021
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Background: It is essential to determine the distribution of the causative microorganisms in the region and the status of local antibiotic resistance for the proper treatment of hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP). This study aimed to investigate the occurrence and causative strains of HAP/VAP, distribution of resistant bacteria, use of antibiotics, and the ensuing outcomes of patients in Korea.
Methods: A multicenter prospective observational cohort study was conducted among patients with HAP/VAP admitted to the medical intensive care unit of 5 tertiary referral centers between August 2012 and June 2015.
Carbapenem Antibiotics for the Empiric Treatment of Nosocomial Pneumonia: A Systematic Review and Meta-analysis.
Chest
March 2021
Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada. Electronic address:
Background: Previous meta-analyses suggested that treating hospital-acquired pneumonia (HAP), including ventilator-associated pneumonia (VAP), with empiric carbapenems was associated with lower mortality rates but higher rates of clinical failure for pseudomonal pneumonia. This study was an updated meta-analysis with sensitivity analyses and meta-regression to better understand the impact of carbapenem use in HAP/VAP.
Research Question: What is the efficacy of carbapenems for empiric treatment of nosocomial pneumonia?
Study Design And Methods: Databases were searched for randomized controlled studies evaluating empiric treatment for HAP and/or VAP, and studies were included comparing carbapenem- vs non-carbapenem-containing regimens.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!