Risk Factors for Acute Kidney Injury in Patients Treated with Polymyxin B: Experience from 139 Cases at a Tertiary University Hospital in Colombia

Gómez, Carlos A.; Barreto, Jackeline; Osorio, Johanna; Alvarez, Luis Carlos Fernandez; Samboni, Claudia F; Ramos, Jorge Andrés; Santofimio, Dagoberto; Benavides, Yudi S; Téllez, Roso P; Candelo, Lina

doi:10.1093/ofid/ofw172.1351

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“…These characteristics limit the options for treating infections caused by KP-NDM. Colistin, gentamicin, tigecycline, and fosfomycin, used in the treatment of these infections, can lead to serious adverse effects, such as nephrotoxicity [5] and hepatotoxicity [6]. Karakonstantis et al presented a therapeutic algorithm depending on the type of carbapenemase produced by carbapenem-resistant K. pneumoniae strains [7].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of 23 patients diagnosed with New Delhi metallo-beta-lactamase (NDM)-producing Klebsiella pneumoniae infection treated with ceftazidime/avibactam and aztreonam at a single center in Poland

Guzek,

Rybicki,

Tomaszewski

et al. 2024

Eur J Clin Microbiol Infect Dis

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Purpose Amongst all etiologic hospital-acquired infection factors, K. pneumoniae strains producing New Delhi metallo-β-lactamase (KP-NDM) belong to pathogens with the most effective antibiotic resistance mechanisms. Clinical guidelines recommend using ceftazidime/avibactam with aztreonam (CZA + AT) as the preferred option for NDM-producing Enterobacterales. However, the number of observations on such treatment regimen is limited. This retrospective study reports the clinical and microbiological outcomes of 23 patients with KP-NDM hospital-acquired infection treated with CZA + AT at a single center in Poland. Methods The isolates were derived from the urine, lungs, blood, peritoneal cavity, wounds, and peritonsillar abscess. In microbiological analysis, mass spectrometry for pathogen identification, polymerase chain reaction, or an immunochromatographic assay for detection of carbapenemase, as well as VITEK-2 system, broth microdilution, and microdilution in agar method for antimicrobial susceptibility tests were used, depending of the pathogens’ nature. CZA was administered intravenously (IV) at 2.5 g every eight hours in patients with normal kidney function, and aztreonam was administered at 2 g every eight hours IV. Such dosage was modified when renal function was reduced. Results KP-NDM was eradicated in all cases. Four patients (17.4%) died: three of them had a neoplastic disease, and one - a COVID-19 infection. Conclusion The combination of CZA + AT is a safe and effective therapy for infections caused by KP-NDM, both at the clinical and microbiological levels. The synergistic action of all compounds resulted in a good agreement between the clinical efficacy of CZA + AT and the results of in vitro susceptibility testing.

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Section: Introductionmentioning

confidence: 99%