دورية أكاديمية
Resistance to empirical β-lactams recommended in febrile neutropenia guidelines in Gram-negative bacilli bloodstream infections in Spain: a multicentre study.
| العنوان: | Resistance to empirical β-lactams recommended in febrile neutropenia guidelines in Gram-negative bacilli bloodstream infections in Spain: a multicentre study. |
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| المؤلفون: | Chumbita M; Hospital Clínic de Barcelona-IDIBAPS, Barcelona, Spain., Puerta-Alcalde P; Hospital Clínic de Barcelona-IDIBAPS, Barcelona, Spain., Yáñez L; Hospital Universitario Marqués de Valdecilla, Santander, Spain., Cuesta MA; Hospital Universitario Virgen de la Victoria, Malaga, Spain., Chinea A; Hospital Universitario Ramón Y Cajal, Madrid, Spain., Español Morales I; Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain., Fernández Abellán P; Hospital General Universitario de Alicante, Alicante, Spain., Gudiol C; Hospital Universitario de Bellvitge, Institut Català d'Oncologia, IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain.; Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Infecciosas (CB21/13/00009), Instituto de Salud Carlos III, Madrid, Spain., Guerreiro M; Hospital Universitario y Politécnico La Fe, Valencia, Spain., González-Sierra P; Hospital Universitario Virgen de las Nieves, Granada, Spain., Rojas R; Hospital Universitario Reina Sofia, Córdoba, Spain., Sánchez Pina JM; Hospital Universitario 12 de Octubre, Madrid, Spain., Sánchez Vadillo I; Hospital Universitario La Paz, Madrid, Spain., Varela R; Hospital Universitario de A Coruña, Coruña, Spain., Vázquez L; Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Lopera C; Hospital Clínic de Barcelona-IDIBAPS, Barcelona, Spain., Monzó P; Hospital Clínic de Barcelona-IDIBAPS, Barcelona, Spain., Garcia-Vidal C; Hospital Clínic de Barcelona-IDIBAPS, Barcelona, Spain. |
| المصدر: | The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2022 Jun 29; Vol. 77 (7), pp. 2017-2023. |
| نوع المنشور: | Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 7513617 Publication Model: Print Cited Medium: Internet ISSN: 1460-2091 (Electronic) Linking ISSN: 03057453 NLM ISO Abbreviation: J Antimicrob Chemother Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1997- : London : Oxford University Press Original Publication: London, New York, Academic Press. |
| مواضيع طبية MeSH: | Bacteremia*/drug therapy , Bacteremia*/epidemiology , Febrile Neutropenia*/drug therapy , Gram-Negative Bacterial Infections*/drug therapy , Gram-Negative Bacterial Infections*/epidemiology , Sepsis*/drug therapy, Anti-Bacterial Agents/therapeutic use ; Cohort Studies ; Gram-Negative Bacteria ; Humans ; Pseudomonas aeruginosa ; Retrospective Studies ; Spain/epidemiology ; beta-Lactams/therapeutic use |
| مستخلص: | Objectives: To describe current resistance to the β-lactams empirically recommended in the guidelines in bloodstream infection (BSI) episodes caused by Gram-negative bacilli (GNB). Methods: Retrospective, multicentre cohort study of the last 50 BSI episodes in haematological patients across 14 university hospitals in Spain. Rates of inappropriate empirical antibiotic therapy (IEAT) and impact on mortality were evaluated. Results: Of the 700 BSI episodes, 308 (44%) were caused by GNB, mainly Escherichia coli (141; 20.1%), Klebsiella spp. (56; 8%) and Pseudomonas aeruginosa (48; 6.9%). Among GNB BSI episodes, 80 (26%) were caused by MDR isolates. In those caused by Enterobacterales, 25.8% were ESBL producers and 3.5% were carbapenemase producers. Among P. aeruginosa BSI episodes, 18.8% were caused by MDR isolates. Overall, 34.7% of the isolated GNB were resistant to at least one of the three β-lactams recommended in febrile neutropenia guidelines (cefepime, piperacillin/tazobactam and meropenem). Despite extensive compliance with guideline recommendations (91.6%), 16.6% of BSI episodes caused by GNB received IEAT, which was more frequent among MDR GNB isolates (46.3% versus 6.1%; P < 0.001). Thirty day mortality was 14.6%, reaching 21.6% in patients receiving IEAT. Conclusions: Current resistance to empirical β-lactams recommended in febrile neutropenia guidelines is exceedingly high and IEAT rates are greater than desired. There is an urgent need to adapt guidelines to current epidemiology and better identify patients with a high risk of developing MDR GNB infection. (© The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.) |
| معلومات مُعتمدة: | Instituto de Salud Carlos III; ISCIII; European Union |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) 0 (beta-Lactams) |
| تواريخ الأحداث: | Date Created: 20220425 Date Completed: 20220701 Latest Revision: 20220706 |
| رمز التحديث: | 20240513 |
| DOI: | 10.1093/jac/dkac135 |
| PMID: | 35466357 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1460-2091 |
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| DOI: | 10.1093/jac/dkac135 |