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Oxa-48 dominance meets ceftazidime-avibactam: A battle against life-threatening carbapenem-resistant klebsiella pneumoniae infections in the intensive care unit

dc.contributor.authorÖnal, Uğur
dc.contributor.authorTüzemen, Ülkü
dc.contributor.authorKaya, Pınar K.
dc.contributor.authorİşçimen, Remzi
dc.contributor.authorGirgin, Nermin Küçükdemirci
dc.contributor.authorÖzakın, Cüneyt
dc.contributor.authorKahveci, Ferda
dc.contributor.authorAkalın, Halis
dc.contributor.buuauthorÖNAL, UĞUR
dc.contributor.buuauthorTÜZEMEN, NAZMİYE ÜLKÜ
dc.contributor.buuauthorKÜÇÜKDEMİRCİ KAYA, PINAR
dc.contributor.buuauthorÖZAKIN, CÜNEYT
dc.contributor.buuauthorKAHVECİ, FERDA ŞÖHRET
dc.contributor.buuauthorİŞÇİMEN, REMZİ
dc.contributor.buuauthorGirgin, Nermin Küçükdemirci
dc.contributor.buuauthorAKALIN, EMİN HALİS
dc.contributor.departmentTıp Fakültesi
dc.contributor.departmentMikrobiyoloji Bölümü
dc.contributor.orcid0000-0001-6194-3254
dc.contributor.orcid0000-0002-8428-8245
dc.contributor.researcheridJCO-3678-2023
dc.contributor.researcheridJCO-2264-2023
dc.contributor.researcheridJNY-9122-2023
dc.contributor.researcheridJMU-3479-2023
dc.contributor.researcheridDTU-3148-2022
dc.contributor.researcheridJNH-9929-2023
dc.contributor.researcheridCYR-2043-2022
dc.contributor.researcheridCYR-2043-2022
dc.contributor.researcheridAAU-8952-2020
dc.date.accessioned2024-06-25T12:58:09Z
dc.date.available2024-06-25T12:58:09Z
dc.date.issued2023-10-10
dc.description.abstractObjectiveIn this study, we aimed to describe the outcomes in ICU patients with bloodstream infection (BSI) or ventilatory-associated pneumonia (VAP) due to carbapenem-resistant Klebsiella pneumoniae (CRKP) who received ceftazidime-avibactam treatment at a tertiary care university hospital.MethodsPatients aged 18 years or older who were admitted to the Anesthesiology and Reanimation ICU at Bursa Uludag University Faculty of Medicine Hospital between June 13, 2021, and July 16, 2023, and diagnosed with BSI or VAP due to CRKP were included in this study.ResultsA total of 42 patients treated with ceftazidimeavibactam were included. Total crude mortality rates were 33.3% on day 14 and 54.8% on day 30. Mortality rates on the 14th and 30th days were 37.5% and 62.5% in patients with BSI and 27.8% and 44.4% in patients with VAP, respectively. There was no statistically significant difference between monotherapy and combination therapy in terms of mortality rates on days 14 and 30, respectively (3/11 vs. 11/31, p=0.620; 5/11 vs. 18/31, p=0.470). Immunosuppression (10/11 vs. 13/31, p=0.005), the Sequential Organ Failure Assessment (SOFA) score >= 8 (at the initiation of treatment; 19/25 vs. 4/17, p<0.001), INCREMENT-CPE score >= 10 (12/16 vs. 3/10, p=0.024) and longer duration (in days) from culture collection to treatment initiation (5.0 +/- 0.61 vs. 3.11 +/- 0.48, p=0.024) were found to have a statistically significant effect on 30-day mortality. In multivariate analysis, a SOFA score >= 8 at the initiation of treatment (p=0.037, OR: 17.442, 95% CI: 1.187-256.280) was found to be a significant risk factor affecting mortality (30-day).ConclusionThe mortality rates of patients with CRKP infection who were followed up in the ICU were found to be high, and it was observed that whether ceftazidime-avibactam treatment was given as a combination or monotherapy did not affect mortality. Further multicentre studies with a larger number of patients are needed to gain a comprehensive understanding of the topic, given that this treatment is typically reserved for documented infections.
dc.identifier.doi10.7759/cureus.46780
dc.identifier.eissn2168-8184
dc.identifier.issue10
dc.identifier.urihttps://doi.org/10.7759/cureus.46780
dc.identifier.urihttps://www.cureus.com/articles/193968-oxa-48-dominance-meets-ceftazidime-avibactam-a-battle-against-life-threatening-carbapenem-resistant-klebsiella-pneumoniae-infections-in-the-intensive-care-unit#!/
dc.identifier.urihttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563373/
dc.identifier.urihttps://hdl.handle.net/11452/42378
dc.identifier.volume15
dc.identifier.wos001089031600032
dc.indexed.wosWOS.ESCI
dc.language.isoen
dc.publisherSpringernature
dc.relation.journalCureus Journal of Medical Science
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCategories
dc.subjectInfectious disease sofa score
dc.subjectVentilatory associated pneumonia
dc.subjectBloodstream infection
dc.subjectCarbapenem-resistant klebsiella pneumoniae
dc.subjectCeftazidime-avibactam
dc.subjectScience & technology
dc.subjectLife sciences & biomedicine
dc.subjectMedicine, general & internal
dc.subjectGeneral & internal medicine
dc.titleOxa-48 dominance meets ceftazidime-avibactam: A battle against life-threatening carbapenem-resistant klebsiella pneumoniae infections in the intensive care unit
dc.typeArticle
dspace.entity.typePublication
local.contributor.departmentTıp Fakültesi/Enfeksiyon Hastalıkları
local.contributor.departmentTıp Fakültesi/Mikrobiyoloji Bölümü
local.contributor.departmentTıp Fakültesi/Anesteziyoloji ve Yoğun Bakım
local.contributor.departmentTıp Fakültesi/Yoğun Bakım Ünitesi
local.contributor.departmentTıp Fakültesi/Tıbbi Mikrobiyoloji
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relation.isAuthorOfPublication.latestForDiscovery73351d49-e518-4e6a-8f69-c922f8f24611

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