학술논문
Efficacy of ceftazidime-avibactam in solid organ transplant recipients with bloodstream infections caused by carbapenemase-producing Klebsiella pneumoniae.
Document Type
Article
Author
Pérez-Nadales, Elena; Fernández-Ruiz, Mario; Natera, Alejandra M.; Gutiérrez-Gutiérrez, Belén; Mularoni, Alessandra; Russelli, Giovanna; Pierrotti, Ligia Camera; Freire, Maristela Pinheiro; Falcone, Marco; Tiseo, Giusy; Tumbarello, Mario; Raffaelli, Francesca; Abdala, Edson; Bodro, Marta; Gervasi, Elena; Fariñas, María Carmen; Seminari, Elena M.; Castón, Juan José; Marín-Sanz, Juan Antonio; Gálvez-Soto, Víctor; Rana, Meenakshi M.; Loeches, Belén; Martín-Dávila, Pilar; Pascual, Álvaro; Rodríguez-Baño, Jesús; Aguado, José María; Martínez-Martínez, Luis; Torre-Cisneros, Julián; Paul, Mical; Carratala, Jordi; Oriol, Isabel; Rodríguez-Álvarez, Regino José; Cordero, Elisa; Lepe, José Antonio; Merino de Lucas, Esperanza; Muñoz, Patricia; Fortún, Jesús; Coussement, Julien; Dewispelaere, Laurent; Eriksson, Britt Marie; van Delden, Christian; Manuel, Oriol; Clemente, Wanessa T.; Varejão Strabelli, Tania Mara; Pilmis, Benoit; Roilides, Emmanuel; Ranganathan N, Iyer; Grossi, Paolo A.; Soldani, Fabio; Rizzi, Marco; Tan, Ban Hock; Lowman, Warren; Gunseren, Filiz; Arslan, Hande; Tufan, Zeliha Koçak; Kazak, Esra; David, Miruna D.; Steinke, Seema Mehta; Ostrander, Darin; Avery, Robin; Lease, Erika D.
Source
American journal of transplantation; 20230101, Issue: Preprints
Subject
Language
ISSN
16006135; 16006143
Abstract
We aimed to compare the efficacy of ceftazidime-avibactam (CAZ-AVI) versusthe best available therapy (BAT) in solid organ transplant (SOT) recipients with bloodstream infection caused by carbapenemase-producing Klebsiella pneumoniae(CPKP-BSI). A retrospective (2016-2021) observational cohort study was performed in 14 INCREMENT-SOT centers (ClinicalTrials.govidentifier: NCT02852902). Outcomes were 14-day and 30-day clinical success (complete resolution of attributable manifestations, adequate source control and negative follow-up blood cultures) and 30-day all-cause mortality. Multivariable logistic and Cox regression analyses adjusted for the propensity score to receive CAZ-AVI were constructed. Among 210 SOT recipients with CPKP-BSI, 149 received active primary therapy with CAZ-AVI (66/149) or BAT (83/149). Patients treated with CAZ-AVI had higher 14-day (80.7% versus 60.6%, P=0.011) and 30-day (83.1% versus 60.6%, P=0.004) clinical success and lower 30-day mortality (13.25% versus 27.3%, P=0.053) than those receiving BAT. In the adjusted analysis, CAZ-AVI increased the probability of 14-day (adjusted odds ratio [aOR]: 2.65; 95% confidence interval [95%CI]: 1.03-6.84, P=0.044) and 30-day clinical success (aOR: 3.14; 95%CI: 1.17-8.40; P=0.023). In contrast, CAZ-AVI therapy was not independently associated with 30-day mortality. In the CAZ-AVI group, combination therapy was not associated with better outcomes. In conclusion, CAZ-AVI may be considered a first-line treatment in SOT recipients with CPKP-BSI.