Ertapenem+meropenem including double carbapenem therapy (EMDCT) versus meropenem+imipenem including double carbapenem therapy (MIDCT) in the therapy of carbapenem-resistant Klebsiella pneumoniae infections (CRKPI): A retrospective matched cohort stud

• Published in: Journal of global antimicrobial resistance. 2024-12, Vol.39, p.3-4
• Main Authors: Vahabi, Merve Mert, Akyol, Deniz, Dağ, Deniz, Şanlıdağ, Gamze, Yeniyol, Şevket, Kaya, Arda, Başkol, Dilşah, Ketentzi, Seichan, Özkara, Buğra, Dirik, Şükrü, Vatansever, Gökhan, Kaya, Derya, Tüğdür, Meltem, Erdem, Hüseyin Aytaç, Çilli, Feriha, Sipahi, Hilal, Pullukçu, Hüsnü, Taşbakan, Meltem, Arda, Bilgin, Sipahi, Oğuz Reşat
• Format: Article
• Language: English
• Subjects: carbapenem resistance; Klebsiella pneumoniae; multidrug resistance
• ISSN: 2213-7165
• DOI: 10.1016/j.jgar.2024.10.009

In this retrospective matched cohort study, we aimed to compare the clinical outcomes of EMDCT including therapy receiving cases with MIDCT receiving CRKPI cases. This study was performed at a 1800+ bedded tertiary-care hospital.Adult patients with culture proven CRKPI(bacteremia,pneumonia,UTI,other)treated with EMDCT or MIDCT including regimens between August 2016 and October 2023 were included in the study.Matching was performed as one MIDCT matched to minimum 1 or 2 EMDCT when n is possible i)according to the sample infecting strain was yielded (bacteremia vs.bacteremia etc.)ii)being in the clinic or intensive care unit at the time of the first Infectious Diseases consultation. MIDCT was used in the ertapenem unavailable period in pan-resistant cases.A total of 140 patients (51 female, aged 64,59±13,46),80 cases in ECDCT group and 60 cases in MIDCT group diagnosed with CRKPN bacteremia(32 cases), pneumonia(34 cases), UTI(48 cases), other(26 cases) were included in the study.All isolates were resistant to ertapenem. Age, gender, duration of therapy, microbiological success, end of therapy clinical success, all cause day-30 mortality in the overall or only double carbapenem or those with any additional antibiotic cohorts as well as UTI and pneumonia subgroups did not differ significantly between two cohorts (Table-1).Prolonged infusion cases were significantly more and OMM in non-bacteremia/pneumonia/UTI cases in wards were significantly less in MIDCT subgroup.However, there was no significant difference in the same subgroup of ICU cases. Although the number of cases is relatively low and non-randomized, EMDCT and MIDCT containing therapy resulted in similar outcomes in our matched cohort study.