Abstract
Herein, we aimed to describe the outcomes of patients with blood stream infections due to carbapenem-resistant Klebsiella pneumoniae (CR-Kp) who received ertapenem plus meropenem combination treatment (EMCT). A total of 53 patients with culture proven CR-Kp bacteremia treated with ertapenem + meropenem were included. The patients with secondary bacteremia due to urinary tract infection exhibited a significantly lower 1-month mortality (OMM), particularly in those with microbiological eradication and those with end-of-treatment success. Salvage EMCT resulted in 49% 1-month survival.
Data availability
The data that support the findings of this study are not publicly available but can be provided with request from the corresponding author, UÖ.
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None available.
References
Tamma PD, Aitken SL, Bonomo RA (2022) Infectious Diseases Society of America antimicrobial-resistant treatment guidance: gram-negative bacterial infections. Infectious Diseases Society of America 2022; Version 1.1. https://www.idsociety.org/practice-guideline/amr-guidance/. Accessed 28 April 2023
Moody RO (2021) The effect of double-carbapenem therapy on mortality rates and microbiological cure rates in patients diagnosed with carbapenem -resistant Klebsiella pneumoniae infections in comparison to monotherapy and currently used combinations of antibiotics: a meta-analysis. J Med Res Innov 5:e000243
Önal U, Sipahi OR, Pullukçu H (2020) Retrospective evaluation of the patients with urinary tract infections due to carbapenemase producing Enterobacteriaceae. J Chemother 32:15–20
Önal U, Akyol D, Mert M (2022) Carbapenem-resistant Gram-negative pathogens associated with septic shock: a review of 120cases. J Chemother 34:436–445
Yy Li, Wang J, Wang R (2020) Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysis. BMC Infect Dis 20:408
CDC, National Healthcare Safety Network (NHSN) Patient safety component manual. (2023). https://www.cdc.gov/nhsn/pdfs/pscmanual/pcsmanual_current.pdf. Accessed 28 April 2023
Paul M, Carrara E, Retamar P (2022) European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines for the treatment of infections caused by multidrug-resistant Gram-negative bacilli (endorsed by European Society of Intensive Care Medicine). Clin Microbiol Infect 28:521–547
Social Security Institution, Health Practice Statement (2021). https://www.saglikaktuel.com/mobi/haber/saglik-uygulama-tebliginde-degisiklik-yapilmasina-dair-teblig-28-04-2021-71706.htm. Accessed 28 April 2023
Noyan A, Sipahi OR, Cilli F, Aydemir S (2022) Ceftazidime-avibactam susceptibility patterns of carbapenem-resistant Klebsiella pneumoniae and Pseudomonas aeruginosa clinical strains in tertiary care educational hospital in Turkey. Europ Conf Clin Microbiol Infect Dis P0554. https://online.eccmid.org/container-intervention-lookup.php?p=1&interv=P0554
Venugopalan V, Nogid B, Le TN (2017) Double carbapenem therapy (DCT) for bacteremia due to carbapenem-resistant Klebsiella pneumoniae (CRKP): from test tube to clinical practice. Infect Dis (Lond) 49:867–870
Souli M, Karaiskos I, Masgala A (2017) Double-carbapenem combination as salvage therapy for untreatable infections by KPC-2-producing Klebsiella pneumoniae. Eur J Clin Microbiol Infect Dis 36:1305–1315
Cprek JB, Gallagher JC (2015) Ertapenem-containing double-carbapenem therapy for treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae. Antimicrob Agents Chemother 60:669–673
Zarakolu P, Eser ÖK, Otlu B (2022) In-vitro activity of fosfomycin against Escherichia coli and Klebsiella pneumoniae bloodstream isolates and frequency of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases in the carbapenem-resistant groups. J Chemother 34:235–240
Allander L, Vickberg K, Lagerbäck P (2022) Evaluation of in vitro activity of double-carbapenem combinations against KPC-2-, OXA-48- and NDM-producing Escherichia coli and Klebsiella pneumoniae. Antibiotics (Basel) 11:1646
Aslan AT, Kırbaş E, Sancak B (2022) A retrospective observational cohort study of the clinical epidemiology of bloodstream infections due to carbapenem-resistant Klebsiella pneumoniae in an OXA-48 endemic setting. Int J Antimicrob Agents 59:106554
Wang M, Earley M, Chen L (2022) Clinical outcomes and bacterial characteristics of carbapenem-resistant Klebsiella pneumoniae complex among patients from different global regions (CRACKLE-2): a prospective, multicentre, cohort study. Lancet Infect Dis 22:401–412
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Author UÖ and author ORS have given substantial contributions to the conception or the design of the manuscript; author UÖ, DA, AK, DB, BK, GŞ, AUÖ, CBA, MM, and SM to acquisition, analysis and interpretation of the data; and author ORS revised it critically.
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This study was approved by the local Institutional Review Board (21-6.1 T/63 on June 25, 2021).
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Önal, U., Akyol, D., Kaya, A. et al. Ertapenem plus meropenem combination treatment in carbapenem-resistant Klebsiella pneumoniae bacteremia: an analysis of 53 cases. Eur J Clin Microbiol Infect Dis 42, 1269–1273 (2023). https://doi.org/10.1007/s10096-023-04660-3
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DOI: https://doi.org/10.1007/s10096-023-04660-3