Uludag University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology - Bursa, Turkey.
Uludag University, Faculty of Medicine, Department of Microbiology - Bursa, Turkey.
Rev Assoc Med Bras (1992). 2023 Oct 9;69(11):e20230727. doi: 10.1590/1806-9282.20230727. eCollection 2023.
The aim of this study was to evaluate the combination treatments with intravenous fosfomycin for carbapenem-resistant Klebsiella pneumoniae infections in a tertiary-care center.
Between December 24, 2018 and November 21, 2022, adult patients diagnosed with bloodstream infection or ventilator-associated pneumonia due to culture-confirmed carbapenem-resistant Klebsiella pneumoniae in the anesthesiology and reanimation intensive care units were investigated retrospectively.
There were a total of 62 patients fulfilling the study inclusion criteria. No significant difference was recorded in 14- and 30-day mortality among different types of combination regimens such as fosfomycin plus one or two antibiotic combinations. Hypokalemia (OR:5.651, 95%CI 1.019-31.330, p=0.048) was found to be a significant risk factor for 14-day mortality, whereas SOFA score at the time of diagnosis (OR:1.497, 95%CI 1.103-2.032, p=0.010) and CVVHF treatment (OR:6.409, 95%CI 1.395-29.433, p=0.017) were associated with 30-day mortality in multivariate analysis.
In our study, high mortality rates were found in patients with bloodstream infection or ventilator-associated pneumonia due to carbapenem-resistant Klebsiella pneumoniae, and no significant difference was recorded in 14- and 30-day mortality among different types of combination regimens such as fosfomycin plus one or two antibiotic combinations.
本研究旨在评估在一家三级保健中心使用静脉注射磷霉素治疗耐碳青霉烯类肺炎克雷伯菌感染的联合治疗方法。
2018 年 12 月 24 日至 2022 年 11 月 21 日，对麻醉和复苏重症监护病房中经培养确认的耐碳青霉烯类肺炎克雷伯菌引起的血流感染或呼吸机相关性肺炎的成年患者进行回顾性调查。
共有 62 名符合研究纳入标准的患者。在不同类型的联合治疗方案（如磷霉素加一种或两种抗生素联合）中，14 天和 30 天死亡率没有显著差异。低钾血症（OR：5.651，95%CI 1.019-31.330，p=0.048）被发现是 14 天死亡率的一个显著危险因素，而诊断时 SOFA 评分（OR：1.497，95%CI 1.103-2.032，p=0.010）和 CVVH 治疗（OR：6.409，95%CI 1.395-29.433，p=0.017）在多变量分析中与 30 天死亡率相关。
在本研究中，耐碳青霉烯类肺炎克雷伯菌引起的血流感染或呼吸机相关性肺炎患者的死亡率较高，在磷霉素加一种或两种抗生素联合等不同类型的联合治疗方案中，14 天和 30 天死亡率没有显著差异。
