Retrospective evaluation of the patients with urinary tract infections due to carbapenemase producing <i>Enterobacteriaceae</i>

Önal, Uğur; Sıpahi, Oğuz Reşat; Pullukçu, Hüsnü; Arda, Bilgin; Ulusoy, Sercan; Aydemir, Şöhret; Taşbakan, Meltem

doi:10.1080/1120009x.2019.1688490

Cited by 12 publications

(8 citation statements)

References 23 publications

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“…Colistin, which has a narrow therapeutic window, has been previously recommended, however, it has still remained controversial in patients with renal dysfunction (5). Double-carbapenem regimen (meropenem and ertapenem) was reported to be an effective option to treat KPC-producing CRE infection, even in patients with meropenem MICs (6,7). Ertapenem which has stronger bonding capability to KPC, is degraded preferentially, and then, the other kinds of carbapenems can be protected (6).…”

Section: Discussionmentioning

confidence: 99%

Meropenem Combined with Ertapenem Rescues a Patient with Multi-Drug Resistant Klebsiella pneumoniae V113 Isolate Infection and Acute-on-Chronic Liver Failure: A Case Report

Chen

et al. 2020

Hepat Mon

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Introduction: Severe infection is a major risk factor for mortality in patients with liver failure. Multidrug-resistant Klebsiella pneumoniae may lead to fatal infection, especially in patients with severe hepatitis. Case Presentation: We describe a 70-year-old Chinese patient with acute-on-chronic liver failure (ACLF) and multidrug-resistant KPC-producing K. peumoniae V113 isolate infection. The serum total bilirubin (TBIL) level was 308.7 µmol/L at the time of admission, and the international normalized ratio (INR) was 2.56. The serum level of TBIL ascended to 526 µmol/L on the 14th day after admission, and then gradually declined. The INR was maintained above 1.5 for 2 months. Creatinine level significantly increased (from 92.5 to 241 µmol/L) in the first month after admission, while estimated glomerular filtration rate declined to 16.9 mL/min 1.73m 2. Diammonium glycyrrhizinate, plasma, as well as albumin were given intravenously. At the time of admission, she had sepsis with symptoms, including fever and shivering, and K. pneumoniae was identified by blood culture test. Biapenem combined with moxifloxacin was shown to be effective, while that could not eliminate the bacteria. Fever and shivering re-occurred, and repeated drug susceptibility tests confirmed the same multidrug-resistant K. pneumoniae isolate without extended-spectrum β-lactamases. Combination treatment of meropenem and ertapenem resulted in a positive clinical outcome without deterioration of liver function. Furthermore, single-molecule real-time (SMRT) sequencing identified 3 genes (blaPKC, blaTXM, and catA2) on the plasmid and 3 genes (blaSHV2, catB3, and arnA) on the chromosome. Moreover, 10 multidrug resistance efflux pump genes and 2 fosmidomycin efflux pump genes were found on the chromosome. Conclusions: Meropenem combined with ertapenem might be used for treating patients with ACLF and multi-drug resistant K. pneumoniae V113 isolate infection.

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Section: Discussionmentioning

confidence: 99%

Meropenem Combined with Ertapenem Rescues a Patient with Multi-Drug Resistant Klebsiella pneumoniae V113 Isolate Infection and Acute-on-Chronic Liver Failure: A Case Report

Chen

et al. 2020

Hepat Mon

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“…The study conducted by De Pascale et al, 2017 (18) was determined to have a moderate risk of bias due to missing data, all other included studies were determined to have a low risk of bias due to missing data (19,20,21,22,23,24). In addition, all studies had low risk of bias in both measurements of outcomes and in selection of the reported result (18,19,20,21,22,23,24). As shown in table 2.…”

Section: Risk Of Bias Assessment Of Included Studiesmentioning

confidence: 99%

“…The studies selected for inclusion were assessed for risk of bias and all included studies were determined to have a moderate risk of bias, with the exception of the study conducted by Gutierrez-Gutierrez et al, 2017, (20) (18,19,20,21,22,23,24). Similarly all included studies were determined to have a low risk of bias due to deviations from intended interventions and in bias due to classification of interventions (18,19,20,21,22,23,24). The study conducted by De Pascale et al, 2017 (18) was determined to have a moderate risk of bias due to missing data, all other included studies were determined to have a low risk of bias due to missing data (19,20,21,22,23,24).…”

Section: Risk Of Bias Assessment Of Included Studiesmentioning

confidence: 99%

“…Similarly all included studies were determined to have a low risk of bias due to deviations from intended interventions and in bias due to classification of interventions (18,19,20,21,22,23,24). The study conducted by De Pascale et al, 2017 (18) was determined to have a moderate risk of bias due to missing data, all other included studies were determined to have a low risk of bias due to missing data (19,20,21,22,23,24). In addition, all studies had low risk of bias in both measurements of outcomes and in selection of the reported result (18,19,20,21,22,23,24).…”

Section: Risk Of Bias Assessment Of Included Studiesmentioning

confidence: 99%

“…Data shown is number of cases achieving microbiological cure (events) and total number in group (total),data shown is odds ratio and 95% confidence interval, events refers to microbiological cure, CI-confidence interval, df-degrees of freedom, SAT-standard antibiotic therapy, DCT-dual carbapenem therapy, experimental group received DCT treatment, control group received standard antibiotic regimes, p<0.05 is significant. Cancelli et al (19), De Pascale et al (18), Onal et al (22), Venugopalan et al (24).…”

Section: Microbiological Cure Rates In Patients Treated With Dct In Cmentioning

confidence: 99%

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The effect of double-carbapenem therapy on mortality rates and microbiological cure rates in patients diagnosed with carbapenem-resistant Klebsiella pneumoniae infections in comparison to monotherapy and currently used combinations of antibiotics

Moody

2021

J Med Res Innov

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Introduction: Infection with the bacteria carpamenease-producing Klebsiella pneumoniae represents a significant cause of mortality in hospitalised patients. These multidrug resistant bacteria are resistant to currently used antibiotics as a result of carbapenemase production. Dual carbapenem therapy has been proposed as a valid therapeutic option, this therapy combines two carbapenem antibiotics, with one acting as a suicide inhibitor allowing the subsequent carbapenem to exert a bactericidal effect. Aim: The aim of this meta-analysis was to determine if dual carbapenem therapy had a significant effect on mortality rate and microbiological cure rate in patients diagnosed with carbapenemase-producing Klebsiella pneumoniae infections in comparison to standard antibiotic therapies. Methods: The search terms “(dual OR double) carbapenem (therapy OR treatment) AND klebsiella pneumoniae” were used to search databases and inclusion and exclusion criteria were applied to retrieved papers, a total of seven studies were identified for inclusion in the meta-analysis. The quality of included studies was assessed using the cochrane tool for risk of bias assessment and funnel plots were produced to determine the influence of publication bias. A random effects model was used to assess the outcomes; mortality rate and microbiological cure rate. Results and Conclusion: Dual carbapenem therapy had a time dependent effect on patient mortality rates. Dual carbapenem therapy significantly lowered mortality rates in patients in comparison to standard antibiotic therapy, especially in comparison to monotherapy treatment regimens. Additionally, dual carbapenem therapy significantly improved microbiological cure rate in patients when compared to standard antibiotic treatment regimens demonstrating the possible clinical applications of a dual carbapenem antibiotic regimen in the treatment of carbapenemase-producing Klebsiella pneumoniae infections.

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Ertapenem plus meropenem combination treatment in carbapenem-resistant Klebsiella pneumoniae bacteremia: an analysis of 53 cases

Önal,

Akyol,

Kaya

et al. 2023

Eur J Clin Microbiol Infect Dis

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Retrospective evaluation of the patients with urinary tract infections due to carbapenemase producing Enterobacteriaceae

Cited by 12 publications

References 23 publications

Meropenem Combined with Ertapenem Rescues a Patient with Multi-Drug Resistant Klebsiella pneumoniae V113 Isolate Infection and Acute-on-Chronic Liver Failure: A Case Report

Meropenem Combined with Ertapenem Rescues a Patient with Multi-Drug Resistant Klebsiella pneumoniae V113 Isolate Infection and Acute-on-Chronic Liver Failure: A Case Report

The effect of double-carbapenem therapy on mortality rates and microbiological cure rates in patients diagnosed with carbapenem-resistant Klebsiella pneumoniae infections in comparison to monotherapy and currently used combinations of antibiotics

Ertapenem plus meropenem combination treatment in carbapenem-resistant Klebsiella pneumoniae bacteremia: an analysis of 53 cases

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