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Ceftazidime–avibactam treatment in bacteremia caused by OXA-48 carbapenemase-producing Klebsiella pneumoniae

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Abstract

Therapeutic options for bacteremia caused by carbapenem-resistant Enterobacterales (CRE) OXA-48-type are limited. The objective of this study was to analyze clinical success of CAZ-AVI compared with best available therapy (BAT) in patients with Klebsiella pneumoniae carbapenemase-producing OXA-48-type bacteremia (CRKp-OXA-48). We conducted a retrospective, single-center observational study in adult patients with CRKp-OXA-48 between December 2015 and May 2019. We collected the patients’ clinical and epidemiological characteristics, antibiotic treatment (CAZ-AVI vs. BAT), and evolution. Factors associated with clinical success were analyzed using binary logistic regression. The study included 76 patients with CRKp-OXA-48-type bacteremia 33 received CAZ-AVI and 43 BAT. CAZ-AVI was mainly used in monotherapy (91%). Clinical success was more common in patients < 70-year-old (OR 4.79, 95% CI [1.435–16.002], p = 0.011) and CAZ-AVI treatment (OR 6.69, 95% CI [1.68–26.604], p = 0.007). Kaplan–Meier survival curve of 14-day mortality showed a lower mortality in patients who received CAZ-AVI (log rank 0.013). However, CAZ-AVI did not achieve statistical difference in IPTW for 14- and 30-day mortality (aOR 0.1, 95% CI [0.02–1.22], p = 0.076 and aOR 1.7, 95% CI [0.48–5.98], p = 0.413, respectively). CAZ-AVI treatment might be associated with a greater clinical success in CRKp-OXA-48 bacteremia.

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Funding

This study was supported by internal funding.

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Authors and Affiliations

  1. Infectious Diseases Unit, Internal Medicine Department, Complexo Hospitalario Universitario de Vigo, Vigo, Spain

    O. Lima, A. Sousa, R. Longueira-Suárez, C. Taboada-Martínez, C. Portela-Pino, A. Nodar, M. Rubianes & MT. Pérez-Rodríguez

  2. Biomedical Research Institute Galicia Sur, Vigo, Spain

    O. Lima, A. Sousa, R. Longueira-Suárez & MT. Pérez-Rodríguez

  3. Vascular Surgery Department, Complexo Hospitalario Universitario de Vigo, Vigo, Spain

    A. Filgueira

  4. Microbiology Department, Complexo Hospitalario Universitario de Vigo, Vigo, Spain

    F. Vasallo-Vidal & L. Martinez-Lamas

  5. Pharmacy Department, Complexo Hospitalario Universitario de Vigo, Vigo, Spain

    A. Pérez-Landeiro

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  1. O. Lima
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Olalla Lima. The first draft of the manuscript was written by Olalla Lima and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to O. Lima.

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When conducting the study, we followed the indications of the Declaration of Helsinki. The study was evaluated and approved by the regional ethics committee (2017/336). STROBE recommendations were followed to ensure the reporting quality of the study.

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Lima, O., Sousa, A., Longueira-Suárez, R. et al. Ceftazidime–avibactam treatment in bacteremia caused by OXA-48 carbapenemase-producing Klebsiella pneumoniae. Eur J Clin Microbiol Infect Dis 41, 1173–1182 (2022). https://doi.org/10.1007/s10096-022-04482-9

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