头孢曲松与头孢吡肟或碳青霉烯类药物用于住院成人低风险安普碳耐药肠杆菌血流感染的最终治疗：一项回顾性队列研究。

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease Pub Date : 2024-10-13 DOI:10.1016/j.diagmicrobio.2024.116557

Jessica L. Mulbah , Rachel M. Kenney , Robert J. Tibbetts , Anita B. Shallal , Michael P. Veve

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引用次数: 0

摘要

目的比较头孢曲松和AmpC稳定疗法对低风险AmpC肠杆菌引起的菌血症患者的治疗效果：方法：经IRB批准，对2017年1月1日-2024年2月28日期间年龄≥18岁、患有马氏沙雷氏菌、摩根氏菌或普罗维登斯菌属菌血症的住院患者进行回顾性队列研究。患者采用头孢曲松与AmpC稳定疗法（头孢吡肟、碳青霉烯）进行比较。主要终点是30天全因死亡率；次要终点是临床失败和头孢曲松耐药性的产生：共纳入 163 名患者；33.1% 的患者接受了头孢曲松治疗，66.9% 的患者接受了 AmpC 稳定疗法。头孢曲松与 AmpC 稳定型患者的 30 天全因死亡率分别为 9.3% 和 10.1%（P = 0.87）；头孢曲松最终疗法与 30 天全因死亡率无关（adjOR，0.79；95 %CI，0.23-2.3）。头孢曲松和AmpC稳定治疗患者的临床失败率（9.3% vs 21.1%，P = 0.059）或复发感染率（5.6% vs 9.3%，P = 0.55）没有差异：结论：接受头孢曲松治疗的低风险AmpC肠杆菌菌血症患者与接受AmpC稳定疗法的患者疗效相似。

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Ceftriaxone versus cefepime or carbapenems for definitive treatment of low-risk AmpC-Harboring Enterobacterales bloodstream infections in hospitalized adults: A retrospective cohort study

Objective

To compare outcomes of ceftriaxone to AmpC-stable therapies in patients with bacteremia caused by low-risk AmpC harboring Enterobacterales.

Methods

IRB-approved, retrospective cohort of hospitalized patients ≥18 years old with Serratia marcescens, Morganella morganii, or Providencia spp. bacteremia from 1/1/2017-2/28/2024. Patients were compared by definitive therapy with ceftriaxone vs AmpC-stable therapy (cefepime, carbapenem). The primary endpoint was 30-day all-cause mortality; secondary endpoints were clinical failure and development of ceftriaxone resistance.

Results

163 patients were included; 33.1 % received ceftriaxone, 66.9 % AmpC-stable therapies. 30-day all-cause mortality was 9.3 % ceftriaxone vs 10.1 % AmpC stable patients (P = 0.87); ceftriaxone definitive therapy was not associated with 30-day all-cause mortality (adjOR, 0.79; 95 %CI, 0.23-2.3). There were no differences in clinical failure (9.3 % vs 21.1 %, P = 0.059) or relapsing infection (5.6 % vs 9.3 %, P = 0.55) between ceftriaxone and AmpC-stable treated patients.

Conclusions

Patients treated with definitive ceftriaxone for low-risk AmpC Enterobacterales bacteremia had similar outcomes to AmpC stable therapies.

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来源期刊

Diagnostic microbiology and infectious disease 医学-传染病学

CiteScore

5.30

自引率

3.40%

发文量

149

审稿时长

56 days

期刊介绍： Diagnostic Microbiology and Infectious Disease keeps you informed of the latest developments in clinical microbiology and the diagnosis and treatment of infectious diseases. Packed with rigorously peer-reviewed articles and studies in bacteriology, immunology, immunoserology, infectious diseases, mycology, parasitology, and virology, the journal examines new procedures, unusual cases, controversial issues, and important new literature. Diagnostic Microbiology and Infectious Disease distinguished independent editorial board, consisting of experts from many medical specialties, ensures you extensive and authoritative coverage.