Efficacy of cefoperazone/sulbactam for ESBL-producing Escherichia coli and Klebsiella pneumoniae bacteraemia and the factors associated with poor outcomes
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Le résumé fourni par la source
OBJECTIVE: We aimed to assess the efficacy of cefoperazone/sulbactam (CPZ/SUL) in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales infections and identify factors influencing outcomes. METHODS: This retrospective multicentre study was conducted in Taiwan (January 2015 to December 2020) and examined the efficacy of CPZ/SUL treatment in ESBL-producing Enterobacterales bacteraemia. The minimum inhibitory concentrations (MICs) were determined using agar dilution; ESBL/AmpC genes were detected using polymerase chain reaction. The primary outcome was clinical success, whereas the secondary outcome was 30-day mortality. Clinical success was defined as the complete resolution of clinical signs and symptoms of K. pneumoniae or E. coli infection, with no evidence of persistent or recurrent bacteraemia. The factors influencing outcomes were identified using a multivariate analysis. RESULTS: CPZ/SUL demonstrated a clinical success rate of 82.7% (91/110) in treating ESBL-producing Enterobacterales bacteraemia, with a 30-day mortality rate of 9.1% (10/110). Among 110 ESBL-producing isolates, a high clinical success rate was observed at an MIC of ≤32/32 mg/L. Multivariate analysis revealed that a Charlson comorbidity index (CCI) of ≥6 was associated with lower clinical success [odds ratio (OR): 5.80, 95% confidence interval (CI): 1.15-29.14, P = 0.033]. High Sequential Organ Failure Assessment scores (≥6) were significantly associated with increased 30-day mortality (OR: 14.34, 95% CI: 1.45-141.82, P = 0.023). DISCUSSION: CPZ/SUL demonstrated a clinical success rate of 82.7% (91/110) in treating ESBL-producing Enterobacterales bacteraemia. Treatment success was evident when the CPZ and SUL MIC was ≤32/32 mg/L. Comorbidities (CCI ≥6) were associated with lower clinical success, while disease severity (Sequential Organ Failure Assessment score ≥6) correlated with higher mortality.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé, mais le titre doit être comparé manuellement.
- Titre Crossref
- Efficacy of cefoperazone/sulbactam for ESBL-producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> bacteraemia and the factors associated with poor outcomes
- Date Crossref
- 06/02/2024
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Kaohsiung Medical University Center for Liquid Biopsy and Cohort Research pays non établi dans la noticeUniversité ou école supérieure
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Kaohsiung Medical University Chung-Ho Memorial Hospital pays non établi dans la noticeÉtablissement de santé
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Waseda University Research Institute for Science and Engineering pays non établi dans la noticeUniversité ou école supérieure
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I-Shou University Department of Medical Laboratory Science pays non établi dans la noticeUniversité ou école supérieure
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Kaohsiung Municipal Ta-Tung Hospital pays non établi dans la noticeÉtablissement de santé
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Chi Mei Medical Center Department of Medicine pays non établi dans la noticeÉtablissement de santé
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Tri-Service General Hospital Department of Internal Medicine pays non établi dans la noticeÉtablissement de santé
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National Defense Medical Center pays non établi dans la noticeÉtablissement de santé
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National Yang Ming Chiao Tung University Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Taipei Veterans General Hospital pays non établi dans la noticeÉtablissement de santé
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Chang Gung Memorial Hospital Department of Internal Medicine pays non établi dans la noticeÉtablissement de santé
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China Medical University Department of Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
Center for Liquid Biopsy and Cohort Research — Kaohsiung Medical University, Kaohsiung Medical University Chung-Ho Memorial Hospital et Research Institute for Science and Engineering — Waseda University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.