European Journal of Clinical Microbiology & Infectious Diseases最新文献

{"title":"Pharmacodynamic target attainment of the synergism of ceftazidime-avibactam in combination with amikacin against OXA-producing extensively drug-resistant or pan drug-resistant (XDR/PDR) Pseudomonas aeruginosa.","authors":"Yixin Kang, Junchang Cui","doi":"10.1007/s10096-025-05090-z","DOIUrl":"10.1007/s10096-025-05090-z","url":null,"abstract":"<p><p>To investigate the pharmacodynamic target attainment of ceftazidime-avibactam (CZA) in combination with amikacin against OXA-producing extensively drug-resistant/ pan-drug-resistant Pseudomonas aeruginosa (XDR/PDR-PA). The minimum inhibitory concentrations (MICs) of CZA and amikacin against OXA-producing XDR/PDR-PA were determined by the checkerboard method, and the combined inhibitory index (FICI) was calculated to evaluate whether the combination of the two antimicrobials has a synergistic effect on OXA-producing XDR/PDR-PA in vitro. The pharmacokinetic (PK) and pharmacodynamic (PD) parameters of CZA and amikacin were combined by Monte Carlo simulation (MCS) to evaluate the cumulative fraction of response (CFR) of the two antimicrobials for the treatment of OXA-producing XDR/PDR-PA infection. The results of synergy tests of CZA in combination with amikacin suggested that 77.3% of XDR/PDR-PA showed synergistic effects. When the PK/PD target was greater than 50, CFR was 97.84% for CZA 2.5 g q8h when CZA in combination with amikacin. CZA in combination with AMK has a synergistic effect in vitro and could be a potential option for treating OXA-producing XDR/PDR-PA infections.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1493-1500"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of cefiderocol treatment in patients with Gram-negative bacterial infections in Spain in the early access programme: results of the PERSEUS study.","authors":"Julian Torre-Cisneros, Benito Almirante, Carmen De La Fuente Martos, Pedro Rascado, Miguel Salavert Lletí, Miguel Sánchez-García, Alex Soriano, Maria Cruz Soriano-Cuesta, A Javier Gonzalez Calvo, Andreas Karas, Jessica Sarda, Stefano Verardi, Ricard Ferrer","doi":"10.1007/s10096-025-05108-6","DOIUrl":"10.1007/s10096-025-05108-6","url":null,"abstract":"<p><strong>Purpose: </strong>We assessed the effectiveness and safety of cefiderocol in patients with Gram-negative bacterial infections, excluding Acinetobacter spp., in the early access programme (EAP) in Spain.</p><p><strong>Methods: </strong>The retrospective, multicentre PERSEUS study (2018-2022) enrolled hospitalised patients with serious Gram-negative infections, except Acinetobacter spp., who received first-time cefiderocol for ≥ 72 h following requests through the EAP. Clinical cure at end of treatment, all-cause mortality at Day 28, cefiderocol use, and adverse drug reactions (ADRs) were the key outcomes.</p><p><strong>Results: </strong>Overall, 261 patients were eligible for analysis. Median (interquartile range) age was 61 (49-68) years, 202 (77.4%) were male and 165 (63.2%) were in the intensive care unit. The most frequent diagnoses were respiratory tract infection (47.9%), intra-abdominal infection (14.6%), and urinary tract infection (14.6%). The median (IQR) duration of cefiderocol treatment was 10 (7-14) days. Overall, the clinical cure rate was 80.5% (210/261) and the 28-day mortality rate was 21.5% (56/261). In patients with Pseudomonas aeruginosa infection (66.7% [n = 174], including 73 [42%] with metallo-β-lactamases), the clinical cure rate was 84.5% (147/174) and the 28-day mortality was 17.2% (30/174). Logistic regression analysis showed that prior antibiotic treatment for > 7 days (OR 0.19, 95% CI 0.05-0.56) and mechanical ventilation (OR 0.32, 95% CI 0.15-0.67) were independent negative predictive factors for clinical cure. ADRs occurred in seven patients, six events resolved, and one was fatal (toxic epidermal necrolysis).</p><p><strong>Conclusions: </strong>Cefiderocol is a valuable option in the treatment of serious Gram-negative bacterial infections, particularly for those caused by P. aeruginosa.</p><p><strong>Clinicaltrials: </strong>GOV: NCT05789199 (Registration date: 16 February 2023).</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1375-1390"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of MALDI-TOF VITEK MS for rapid and efficient identification of KPC-type carbapenemases in Enterobacterales carrying the Tn4401a transposon.","authors":"Aleyda M Montaño, Carlos Robledo, Julián C Galvis-Ayala, J Natalia Jimenez, Romain Brunel, Jaime Robledo","doi":"10.1007/s10096-025-05097-6","DOIUrl":"10.1007/s10096-025-05097-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine diagnostic validity of MALDI-TOF MS (VITEK MS) system for detecting Klebsiella pneumoniae carbapenemases (KPC)-type carbapenemases by identifying the 11,109 Da peak in the mass spectrum generated for species identification as compared to RAPIDEC^® CARBA NP, and the modified carbapenemase inactivation method (mCIM) and the EDTA-modified carbapenem inactivation method (eCIM) in a collection of isolates previously characterized as KPC positive or negative.</p><p><strong>Methods: </strong>210 Enterobacterales clinical strains previously characterized having bla_KPC gene, the pKpQIL plasmid and the Tn4401a transposon were evaluated, including 34 positive controls carbapenemase-producing Klebsiella pneumoniae associated with Tn4401a, 30 Enterobacterales bla_KPC positive of unknown plasmid background, and 146 negative controls. Accuracy and agreement were established for Vitek MS, RAPIDEC^® CARBA NP, and mCIM/eCIM) tests; ROC curves were compared among these tests.</p><p><strong>Results: </strong>The 11,109 Da peak was detected in 100% of KPC Tn4401a positive isolates using Vitek MS, sensitivity of 100% (95% CI 98.53-100), specificity of 95.5% (95% CI 91.7-99.4), positive predictive value (PPV) of 85.0 (95% CI 72.7-97.3), negative predictive value (NPV) of 100% (95% CI 99.6-100) and positive Likelihood Ratio (PLR) of 22.3 (10.2-48.8). Agreement between the three tests was 93.3% Kappa index of 0.90 (95% CI 0.83-0.97, p ≤ 0.05). ROC curves showed areas under the curve (AUCs) of 0.95, 0.96 and 0.96 for the VITEK MS, RAPIDEC CARBA NP and the mCIM/eCIM tests, respectively.</p><p><strong>Conclusion: </strong>Detection of the 11,109 Da peak by Vitek MS confirms the presence of KPC-type carbapenemase, allowing rapid and simultaneous detection with species identification; a negative result does not rule out the presence of the enzyme and may require additional tests.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1443-1453"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigational antibiotic cefepime/zidebactam as a therapeutic option for the treatment of an unyielding empyema in a paediatric patient caused by extensively drug-resistant Pseudomonas aeruginosa: a case report.","authors":"Vishnu Rao Polati, Santosh Gattu, Venkata Nagarjuna Maturu, P Swati Prakasham, Maryam Maqsood","doi":"10.1007/s10096-025-05106-8","DOIUrl":"10.1007/s10096-025-05106-8","url":null,"abstract":"<p><strong>Objective: </strong>Treatment option for the infections caused by MBL-producing P. aeruginosa is severely limited. Cefepime/zidebactam (WCK 5222) is a novel β-lactam/ β-lactam-enhancer combination, currently in global Phase 3 clinical development. It is reported to show a broad-spectrum in vitro activity and translational efficacy in non-clinical PK/PD models against carbapenem-resistant Gram-negative bacteria including MBL-producing P. aeruginosa. We present a case of a 13-year-old girl, suffering from tuberculosis with a refractory lung empyema caused by NDM-producing, XDR P. aeruginosa who did not respond to several rounds of colistin or aztreonam plus ceftazidime/avibactam therapies albeit effective source control, over 4 months period.</p><p><strong>Methods: </strong>The infecting organism was found to be susceptible to cefepime/zidebactam. After obtaining informed consent and necessary approvals, the patient was treated under compassionate ground.</p><p><strong>Results: </strong>The patient was treated with adult dose regimen of cefepime/zidebactam (due to higher body weight) for 21 days that led to clinical and microbiological cure.</p><p><strong>Conclusion: </strong>This case highlights both severity of the antimicrobial resistance and hope offered by an under-trial novel antibiotic.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1349-1355"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE: 'Catheter replacement in catheter-associated urinary tract infection: current state of evidence' by Westgeest et al.","authors":"Jodie Langbeen, Frederik Van Hoecke, Veroniek Saegeman, Dana Van Kerkhoven, Hilde Jansens, Nicole Depont, Dirk Vogelaers","doi":"10.1007/s10096-025-05089-6","DOIUrl":"10.1007/s10096-025-05089-6","url":null,"abstract":"","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1531-1532"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological, clinical and microbiological aspects of infective endocarditis in Türkiye.","authors":"Elif M Saricaoglu, Seniha Basaran, Derya Seyman, Merve Arslan, Serpil Ozkan-Ozturk, Yasemin Tezer-Tekce, Yesim Uygun-Kizmaz, Nuran Sari, Denef Berzeg-Deniz, Alpay Azap, Serap Simsek-Yavuz, Ozlem Kurt-Azap","doi":"10.1007/s10096-025-05095-8","DOIUrl":"10.1007/s10096-025-05095-8","url":null,"abstract":"<p><strong>Purpose: </strong>Infective endocarditis (IE) is a evolving disease with a shifting epidemiology and disease burden over time. This study aimed to compare the epidemiological and clinical aspects of IE over three time periods across eleven years.</p><p><strong>Methods: </strong>This was a retrospective cohort, multicenter study conducted in Türkiye, comparing three periods: 2013-2016, 2017-2020, and 2021-2023. Epidemiological and microbiological characteristics, as well as patient outcomes, were analyzed and compared across these periods.</p><p><strong>Results: </strong>A total of 1,044 patients diagnosed with IE were included. The median (Q1-Q3) age was 57 (44-68) years, with an increasing pattern (p < 0.001). Throughout the study period, the prevalence of intracardiac devices increased, whereas the prevalence of degenerative and congenital heart diseases declined. Among all patients, the most frequently identified pathogens were staphylococci (36.4%), followed by streptococci (14.0%) and enterococci (11.9%). Throughout the three periods, there was a significant increase in staphylococci, with S. aureus emerging as the predominant pathogen in all type IE. The in-hospital mortality rate among all patients was 22.5%. Independent risk factors for in-hospital mortality included ≥ 65 age(OR = 1.9), chronic kidney disease (OR = 1.9), nosocomial acquisition (OR = 2.1), Candida spp. infection (OR = 2.9), prosthetic valve IE (OR = 1.9), vegetation size > 15 mm (OR = 1.6), and central nervous system emboli (OR = 2).</p><p><strong>Conclusion: </strong>The epidemiology of IE is undergoing significant changes, leading to shifts in microbiological profiles and clinical presentations. Effective management of IE should be guided by established clinical guidelines while integrating up-to-date epidemiological data to ensure comprehensive and evidence-based patient care.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1325-1333"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large DNA fragment ISEc9-mediated transposition during natural transformation allows interspecies dissemination of antimicrobial resistance genes.","authors":"Sara Domingues, Tiago Lima, Corentin Escobar, Julie Plantade, Xavier Charpentier, Gabriela Jorge da Silva","doi":"10.1007/s10096-025-05113-9","DOIUrl":"10.1007/s10096-025-05113-9","url":null,"abstract":"<p><strong>Purpose: </strong>Antimicrobial resistance poses a significant global health challenge, contributing to a lack of effective therapeutic agents, especially against Gram-negative bacteria. Resistance dissemination is accelerated by horizontal gene transfer (HGT) mechanisms. The extended-spectrum beta lactamases CTX-M confer resistance to several beta-lactams, are usually embedded into plasmids and thought to be mainly disseminated by conjugation. However, an increasing number of isolates carry these enzyme-encoding genes in the chromosome, suggesting that they can spread by other means of HGT. In this study, we aimed to test the involvement of natural transformation in the chromosomal acquisition of a bla_CTX-M gene.</p><p><strong>Methods: </strong>Natural transformation assays were performed during motility on wet surfaces. Acquisition of foreign DNA by transformants was screened by antimicrobial susceptibility testing, polymerase-chain reaction (PCR) and whole genome sequencing (WGS).</p><p><strong>Results: </strong>Acinetobacter baumannii A118, a naturally competent clinical strain, was transformed with naked DNA from Salmonella enterica serovar Typhimurium Sal25, which was isolated from swine meat. The transformation occurred at low frequency (2.7 × 10^- 8 ± 2.04 × 10^- 8 transformants per recipient) and bla_CTX-M was acquired in one transformant, which was named ACI. WGS of the transformant revealed the acquisition of the bla_CTX-M-32 as part of a ca. 36 Kb DNA fragment through an ISEc9-mediated transposition event; various mobile genetic elements and other resistance genes were co-transferred. The bla_CTX-M-32 gene was subsequently transferred within A. baumannii at a higher frequency (1.8 × 10^- 6 ± 2.49 × 10^- 6 transformants per recipient).</p><p><strong>Conclusion: </strong>Our results highlight the importance of natural transformation events in the dissemination of antimicrobial resistance genes and mobile genetic elements between and within species.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1417-1424"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and associated factors of macrolide-resistant mycoplasma pneumoniae pneumonia in children: a systematic review and meta-analysis.","authors":"Shuo Yang, Xinying Liu, Yaowei Han, Huizhe Wang, Yunzheng Mei, Haokai Wang, Na Zhang, Yingying Peng, Xinmin Li","doi":"10.1007/s10096-025-05101-z","DOIUrl":"10.1007/s10096-025-05101-z","url":null,"abstract":"&lt;p&gt;&lt;p&gt;In recent years, the incidence of macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia has markedly increased across East Asia, especially in China, Japan, and South Korea, presenting considerable challenges for clinical management. We systematically reviewed and conducted a meta-analysis on the resistance rate, clinical characteristics, and associated factors of MRMP, thereby establishing a foundation for early clinical identification and optimization of treatment strategies. In accordance with the PRISMA 2020 reporting guidelines, six databases including PubMed, Embase, Web of Science, CNKI, VIP, and Wanfang Data were systematically searched for relevant literature up to October 31, 2024. Studies explicitly reporting the clinical characteristics of both MRMP and macrolide-sensitive Mycoplasma pneumoniae (MSMP) pneumonia patients were included, with the population restricted to children. Pooled odds ratio (OR) and mean difference (MD), along with 95% confidence intervals, were calculated using inverse-variance weighting. A significance threshold was set at p &lt; 0.05, and meta-analysis was performed using software such as RevMan, Stata, and R Studio. A total of 65 studies encompassing 20,141 patients were included in this analysis. The meta-analysis revealed that MRMP showed high resistance in East Asia compared to lower resistance in other regions. The overall resistance rate was 61% (95% CI: 54%, 68%), exhibiting notable regional variation. Elevated resistance rates were noted in East Asian countries, specifically China, Japan, and South Korea, reported at 68% (95% CI: 63%, 73%), 61% (95% CI: 43%, 80%), and 63% (95% CI: 42%, 85%), respectively. MRMP resistance was significantly associated with prolonged fever duration (MD: 1.97, 95% CI: 1.10, 2.84), extended hospitalization (MD: 1.96, 95% CI: 1.39, 2.54), elevated log MP-DNA levels (MD: 2.79, 95% CI: 1.54, 4.04), increased proportions of severe (OR: 2.45, 95% CI: 1.75, 3.44) cases and refractory (OR: 3.25, 95% CI: 1.47, 7.17) cases, and the occurrence of complications, particularly intrapulmonary manifestations including pulmonary consolidations (OR: 1.43, 95% CI: 1.14, 1.78), pleural effusions (OR: 2.11, 95% CI: 1.28, 3.49), lobar lesions (OR: 2.03, 95% CI: 1.03, 4.00), mucus plugs (OR: 4.63, 95% CI: 1.66, 12.94), and necrotizing pneumonia (OR: 2.49, 95% CI: 1.19, 5.24), alongside extrapulmonary involvement (OR: 3.08, 95% CI: 2.49, 3.82). No significant differences were observed in peak body temperature (MD: 0.05, 95% CI: -0.11, 0.20) or inflammatory markers including white blood cell count (WBC, MD: 0.28, 95% CI: -0.38, 0.94), C-reactive protein (CRP, MD: 0.71, 95% CI: -2.16, 3.58), Procalcitonin (PCT, MD: -0.11, 95% CI: -0.27, 0.05) and lactate dehydrogenase (LDH, MD: 3.80, 95% CI: -22.92, 30.52). The high resistance rate may be associated with environmental pressure stemming from the widespread use of macrolide antibiotics and increased genetic mutations due to the extensive spre","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1505-1522"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance evaluation of a novel MBT LipidART module (Bruker Daltonics) for detection of colistin resistance in Escherichia coli and Klebsiella pneumoniae.","authors":"Julija Germ, Mateja Pirs","doi":"10.1007/s10096-025-05099-4","DOIUrl":"10.1007/s10096-025-05099-4","url":null,"abstract":"<p><p>We evaluated the MBT LipidART module on a MALDI Biotyper® Sirius System (Bruker Daltonics) for the rapid detection of colistin resistance in Escherichia coli (EC) and Klebsiella pneumoniae (KPN) by analysing lipid A profiles in negative ion mode. Categorical agreement was achieved for 98.3% EC (N = 58) and 85.0% KPN (N = 40). Challenges included calibration difficulties, limited availability of compatible equipment and issues with mucoid and adherent KPN isolates that yielded invalid results. While MBT LipidART module shows promise as a rapid tool for detection of colistin resistance, its performance was notably better for EC compared to KPN.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1501-1504"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ceftazidime-avibactam use in hematology patients: single-center experience.","authors":"Aysun Halacoglu, Mustafa Koroglu, Mehmet Ozen","doi":"10.1007/s10096-025-05107-7","DOIUrl":"10.1007/s10096-025-05107-7","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy of the cephalosporin/ beta lactamase inhibitor combination ceftazidime-avibactam in hematology patients with hematopoietic stem cell transplantation or receiving chemotherapy alone.</p><p><strong>Materials and methods: </strong>In this study, 80 patients who were followed up in the Stem Cell Transplant Center and Hematology Clinic of Istinye University Gaziosmanpaşa Medicalpark Hospital between June 2022 and May 2024 and who received ceftazidime-avibactam treatment for at least 3 days during their hospitalization were evaluated. Demographic characteristics, infectious processes, duration of hospitalization before culture, neutrophil levels and neutropenia duration at the time of treatment initiation, previous antibiotic exposure, Charlson's Comorbidity index, mechanical ventilation needs and mortality rates were recorded retrospectively.</p><p><strong>Results: </strong>Of the patients, 25 (31.25%) were female and 55 (68.75%) were male. The mean age was 50 years (18-86). Thirty-four (42.5%) patients received allogeneic hematopoietic stem cell transplantation and 17 (21.25%) patients received autologous hematopoietic stem cell transplantation. Only 29 (36.25%) patients received chemotherapy. When ceftazidime-avibactam treatment was initiated, 42 (52.5%) patients had a neutrophil count < 0.1 × 10⁹/L. Charlson's Comorbidity Index was ≥ 3 in 71 (88.75%) patients. Forty-six (57.5%) patients died in the first 28 days after the onset of infection. In multivariate analysis showed that mean age (HR 1.71, CI 1.07-3.05; p = 0.012), pneumonia and need for mechanical ventilation (HR 1.91, CI 1.83-1.98; p = 0.001), clinical improvement status in the first 14 days (HR 1.02, CI 0.97-1.08; p = 0.001) and duration of neutropenia (HR 2.67, CI 2.26-3.08; p = 0.019) were independent risk factors associated with 28-day mortality.</p><p><strong>Conclusion: </strong>Mortality due to resistant microorganisms is high in hematologic patients during stem cell transplantation and non-transplant period. Age, pneumonia and need for mechanical ventilation and duration of neutropenia are the most important mortality indicators in hematologic patients. Ceftazidime-avibactam is an effective treatment option in appropriate patients and the clinical response will be better if it can be started before the need for mechanical ventilation develops.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1335-1339"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}