Faculty of Medicine, Cukurova University, Adana, Turkey.
Department of Pediatric Infectious Diseases, Balcalı Hospital, Sarıçam, Adana, Turkey.
Eur J Clin Microbiol Infect Dis. 2024 Dec;43(12):2361-2369. doi: 10.1007/s10096-024-04948-y. Epub 2024 Oct 1.
Klebsiella pneumoniae is a significant cause of healthcare-associated infections, resulting in high morbidity and mortality rates due to limited treatment options. In this study, we aimed to evaluate the treatment outcomes and the safety of Ceftazidime-avibactam in infections caused by extensively drug-resistant or pandrug-resistant Klebsiella pneumoniae in pediatric patients.
This study included pediatric patients who received ceftazidime-avibactam treatment due to extensively drug-resistant or pandrug-resistant Klebsiella pneumoniae infections, monitored in the pediatric intensive care, neonatal intensive care, and pediatric wards of Cukurova University Faculty of Medicine between 2022 and 2023. Patients' microbiological responses, clinical responses, medication side effects, and 30-day survival rates were evaluated.
Eleven pediatric patients were included in the study, of whom nine were male (81.8%). The median age at the initiation of ceftazidime-avibactam treatment was 15 months (range: 14 days-183 months). Sepsis was diagnosed in 9 patients (81.8%). Two premature infants (27 and 35 weeks) were admitted to the neonatal ICU. Regarding the Klebsiella pneumoniae strains, 10 (91%) were extensively drug-resistant (XDR), and 1 (9%) was pandrug-resistant (PDR). Eight strains (72.7%) were carbapenem-resistant, and 9 (81.8%) were colistin-resistant. Microbiological response was noted in 8 patients (72.7%), clinical response was evident in 6 patients (54.5%). The 30-day survival rate was 54.5%, with six patients surviving.
In our study, ceftazidime-avibactam has been identified as a significant treatment option for resistant Klebsiella pneumoniae infection in critically ill children and premature infants with sepsis and organ failure, and it has been found to be well tolerated.
肺炎克雷伯菌是导致医疗保健相关性感染的重要原因，由于治疗选择有限，其导致的发病率和死亡率很高。在本研究中，我们旨在评估头孢他啶-阿维巴坦治疗儿童患者中广泛耐药或全耐药肺炎克雷伯菌感染的治疗效果和安全性。
本研究纳入了 2022 年至 2023 年在库鲁瓦大学医学院儿科重症监护病房、新生儿重症监护病房和儿科病房因广泛耐药或全耐药肺炎克雷伯菌感染而接受头孢他啶-阿维巴坦治疗的儿科患者。评估了患者的微生物学反应、临床反应、药物副作用和 30 天生存率。
本研究纳入了 11 名儿科患者，其中 9 名为男性（81.8%）。开始使用头孢他啶-阿维巴坦治疗的中位年龄为 15 个月（范围：14 天-183 个月）。9 例（81.8%）患者诊断为败血症。2 例早产儿（27 和 35 周）入住新生儿重症监护病房。关于肺炎克雷伯菌菌株，10 株（91%）为广泛耐药（XDR），1 株（9%）为全耐药（PDR）。8 株（72.7%）为碳青霉烯耐药，9 株（81.8%）为多粘菌素耐药。8 例（72.7%）患者的微生物学反应得到改善，6 例（54.5%）患者的临床反应得到改善。30 天生存率为 54.5%，有 6 例患者存活。
在本研究中，头孢他啶-阿维巴坦被确定为治疗患有败血症和器官衰竭的危重症儿童和早产儿中耐药肺炎克雷伯菌感染的重要治疗选择，且具有良好的耐受性。
