@article{10902/32344,
year = {2023},
url = {https://hdl.handle.net/10902/32344},
abstract = {We aimed to compare the efficacy of ceftazidime-avibactam (CAZ-AVI) versus the 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.gov identifier: NCT02852902; Impact of Specific Antimicrobials and MIC Values on the Outcome of Bloodstream Infections Due to ESBL- or Carbapenemase-producing Enterobacterales in Solid Organ Transplantation: an Observational Multinational Study). 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% vs 60.6%, P = .011) and 30-day (83.1% vs 60.6%, P = .004) clinical success and lower 30-day mortality (13.25% vs 27.3%, P = .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 [CI], 1.03-6.84; P = .044) and 30-day clinical success (aOR, 3.14; 95% CI, 1.17-8.40; P = .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},
publisher = {Wiley Periodicals Inc.},
publisher = {American journal of transplantation, 2023, 23(7), 1022-1034},
title = {Efficacy of ceftazidime-avibactam in solid organ transplant recipients with bloodstream infections caused by carbapenemase-producing Klebsiella pneumoniae},
author = {Pérez-Nadales, Elena and Fernández-Ruiz, Mario and Natera, Alejandra M. and Gutiérrez-Gutiérrez, Belén and Mularoni, Alessandra and Russelli, Giovanna and Camera Pierrotti, Ligia and Pinheiro Freire, Maristela and Falcone, Marco and Riseo, Giusy and Tumbarello, Mario and Raffaelli, Francesca and Abdala, Edson and Bodro, Marta and Gervasi, Elena and Fariñas Álvarez, María del Carmen and Seminari, Elena M. and Castón, Juan José and Marín-Sanz, Juan Antonio and Gálvez-Soto, Víctor},
}