Treatment of ventilator-associated pneumonia due to carbapenem-resistant Gram-negative bacteria with novel agents: a contemporary, multidisciplinary ESGCIP perspective

Giacobbe, Daniele Roberto; Roberts, Jason A.; Abdul‐Aziz, Mohd H.; Montmollin, Étienne de; Timsit, Jean‐François; Bassetti, Matteo

doi:10.1080/14787210.2022.2063838

Cited by 6 publications

(4 citation statements)

References 169 publications

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“…The debate about the most valuable option to use these new drugs, is still open, especially regarding the choice between monotherapy and combination therapy. Recommendations are not univocal for MDROs: clinical setting, pathogen isolation, infection source and disease’s severity assessment should guide the prescription [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Meropenem/Vaborbactam and Cefiderocol as Combination or Monotherapy to Treat Multi-Drug Resistant Gram-Negative Infections: A Regional Cross-Sectional Survey from Piedmont Infectious Disease Unit Network (PIDUN)

Lupia

Corcione

Shbaklo

et al. 2022

JFB

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Meropenem/vaborbactam (MV) and cefiderocol were recently approved by the Food and Drug Administration and European Medicines Agency and are among the most promising antibacterial in treatment regimens against multi-drug resistant (MDR) gram-negative bacilli. A survey with close-ended questions was proposed to infectious disease (ID) and intensive care unit (ICU) physicians of Piedmont and Valle d’Aosta Region’s hospitals. The aim was to collect data about habits and prescriptions of cefiderocol and MV. Twenty-three physicians (11 ID specialists and 12 anesthesiologists) in 13 Italian hospitals took part in the survey. Both cefiderocol and MV were mostly used as target therapy after a previous treatment failure and after ID specialist consult. The most frequent MDR pathogen in hospitals was Klebsiella pneumoniae carbapenemase-producing bacteria (KPC), followed by P. aeruginosa and A. baumannii. MDRs were more frequently isolated in ICU. In conclusion, cefiderocol was used in empiric regimens when A.baumannii was suspected, while MV was more used in suspect of KPC. MV and cefiderocol can be the first option in empiric treatment for critically ill patients in settings with high risk of MDR. The treatment should then be followed by rapid de-escalation when microbiological results are available.

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Section: Discussionmentioning

confidence: 99%

Meropenem/Vaborbactam and Cefiderocol as Combination or Monotherapy to Treat Multi-Drug Resistant Gram-Negative Infections: A Regional Cross-Sectional Survey from Piedmont Infectious Disease Unit Network (PIDUN)

Lupia

Corcione

Shbaklo

et al. 2022

JFB

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“…In summary, the modest benefits in bacterial clearance of highly resistant GNB observed with nebulized AGs do not necessarily lead to improved clinical outcomes and may be offset by poor tolerance of nebulization, particularly in patients with significant oxygenation impairment. Nebulized AG use should be restricted to ICUs experienced in antibiotic nebulization, employing checklists and specific monitoring to minimize misuse and adverse effects [104]. The risk/benefit ratio of nebulized AGs may be optimized when employed to target MDR GNB, preferably during the early treatment when inoculum levels and resistance emergence risks are high.…”

Section: Benefits Of Inhaled Aminoglycosides As Adjunctive Therapymentioning

confidence: 99%

Aminoglycosides for the Treatment of Severe Infection Due to Resistant Gram-Negative Pathogens

2023

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Aminoglycosides are a family of rapidly bactericidal antibiotics that often remain active against resistant Gram-negative bacterial infections. Over the past decade, their use in critically ill patients has been refined; however, due to their renal and cochleovestibular toxicity, their indications in the treatment of sepsis and septic shock have been gradually reduced. This article reviews the spectrum of activity, mode of action, and methods for optimizing the efficacy of aminoglycosides. We discuss the current indications for aminoglycosides, with an emphasis on multidrug-resistant Gram-negative bacteria, such as extended-spectrum β-lactamase-producing Enterobacterales, carbapenemase-producing Enterobacterales, multidrug-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii. Additionally, we review the evidence for the use of nebulized aminoglycosides.

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“…MDR organisms are a world health problem causing about 33,000 deaths per year in Europe [7] and 35,000 in the United States [8]. It becomes even more serious when the infection affects critically ill patients, e.g., those admitted to intensive care units (ICUs) [9,10], because it is associated with increased mortality [11]. However, this is not only a humanrelated problem, because MDR bacteria are frequently found in the environment [12], especially in intensive farming both in agriculture (livestock and poultry) [13][14][15] and in aquaculture [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

A NLP Pipeline for the Automatic Extraction of a Complete Microorganism’s Picture from Microbiological Notes

Mora

Attene²,

Gazzarata³

et al. 2022

JPM

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The Italian “Istituto Superiore di Sanità” (ISS) identifies hospital-acquired infections (HAIs) as the most frequent and serious complications in healthcare. HAIs constitute a real health emergency and, therefore, require decisive action from both local and national health organizations. Information about the causative microorganisms of HAIs is obtained from the results of microbiological cultures of specimens collected from infected body sites, but microorganisms’ names are sometimes reported only in the notes field of the culture reports. The objective of our work was to build a NLP-based pipeline for the automatic information extraction from the notes of microbiological culture reports. We analyzed a sample composed of 499 texts of notes extracted from 1 month of anonymized laboratory referral. First, our system filtered texts in order to remove nonmeaningful sentences. Thereafter, it correctly extracted all the microorganisms’ names according to the expert’s labels and linked them to a set of very important metadata such as the translations into national/international vocabularies and standard definitions. As the major result of our pipeline, the system extracts a complete picture of the microorganism.

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Treatment of ventilator-associated pneumonia due to carbapenem-resistant Gram-negative bacteria with novel agents: a contemporary, multidisciplinary ESGCIP perspective

Cited by 6 publications

References 169 publications

Meropenem/Vaborbactam and Cefiderocol as Combination or Monotherapy to Treat Multi-Drug Resistant Gram-Negative Infections: A Regional Cross-Sectional Survey from Piedmont Infectious Disease Unit Network (PIDUN)

Meropenem/Vaborbactam and Cefiderocol as Combination or Monotherapy to Treat Multi-Drug Resistant Gram-Negative Infections: A Regional Cross-Sectional Survey from Piedmont Infectious Disease Unit Network (PIDUN)

Aminoglycosides for the Treatment of Severe Infection Due to Resistant Gram-Negative Pathogens

A NLP Pipeline for the Automatic Extraction of a Complete Microorganism’s Picture from Microbiological Notes

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