VII centenario de la Universidad de Salamanca

Vega, Ingrit Gutiérrez

doi:10.36576/summa.6228

Cited by 3 publications

(3 citation statements)

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“…Clinical trial data on the management of these infections are lacking. However, findings from observational studies have supported the use of combination regimens that include drugs displaying in vitro activity against the K. pneumoniae isolates (eg, aminoglycosides, colistin, fosfomycin, and/or tigecycline) and/or drugs to which K. pneumoniae isolates are in vitro resistant (ie, carbapenems), at least in patients with severe infections [12,[31][32][33][34]. Furthermore, the prevalence of resistance to 1 or more of the few drugs considered active against carbapenem-resistant K. pneumoniae isolates is increasing.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Ceftazidime-Avibactam Salvage Therapy in Patients With Infections Caused byKlebsiella pneumoniaeCarbapenemase–producingK. pneumoniae

Tumbarello

Trecarichi

Corona

et al. 2018

Clinical Infectious Diseases

302

195

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Section: Discussionmentioning

confidence: 99%

Efficacy of Ceftazidime-Avibactam Salvage Therapy in Patients With Infections Caused byKlebsiella pneumoniaeCarbapenemase–producingK. pneumoniae

Tumbarello

Trecarichi

Corona

et al. 2018

Clinical Infectious Diseases

302

195

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“…Delays in blood culture (BC) results may delay the initiation of appropriate antibiotic treatment, increasing the risk of death. 2,3 Best practice standards have been proposed for various aspects of blood culturing [4][5][6][7] ; because it is a multistep process involving clinical, ancillary, and laboratory staff across many departments, there are multiple opportunities for failure to meet these standards. Neither clinicians nor microbiologists are solely responsible for overseeing the blood culturing process.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Blood Culture Collection and Laboratory Processing Practices in Israel

et al. 2022

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ImportanceBlood culturing is a critical diagnostic procedure affecting patient outcomes and antibiotic stewardship. Although there are standards for blood culturing, the process is not often measured.ObjectivesTo evaluate processes related to the diagnosis of bloodstream infection and compare them with best practices.Design, Setting, and ParticipantsA quality improvement study using laboratory data from January 1 to June 30, 2019, was conducted in 28 (96.6%) Israeli acute care hospitals. All blood cultures (BCs) performed on samples from adults and children in a period of 147 hospital-months were analyzed. Data analysis was performed from April 12, 2021, to September 9, 2022.Main Outcomes and MeasuresTrue pathogen detection rate, contamination rate, proportion of adults with blood cultures performed, proportion of adult culturing episodes with only 1 set or bottle used, and median time of steps from sample collection to pathogen identification.ResultsThe data set consisted of 348 987 BC bottles. Bloodstream infection was detected in a median of 6.7% (IQR, 5.8%-8.2%) of adult culturing episodes and 1.1% (IQR, 0.7%-1.9%) of pediatric episodes. Eleven of 27 hospitals (40.7%) with adult patients met the standard of a contamination rate of less than 3% and only 2 hospitals (7.4%) met the more stringent standard of less than or equal to 1% contamination rate. The percentage of adults with blood cultures ranged from 2.7% to 29.0% (mean [SD], 15.7% [6.0%]). There was an association between sampling rate and pathogen detection until BCs were performed in 17% of adult admissions. The percentage of solitary BCs ranged from 47.8% to 94.4%. An estimated 1745 of 7436 (23.5%) adult bloodstream infections went undetected because solitary BCs were performed, anaerobic bottles were not used, or BCs were not performed. Median processing time was 51.2 (IQR, 33.9-78.0) hours, 3 times the optimal time: 4.4 (IQR, 1.7-12.5) hours for the preanalytical stage, 15.9 (IQR, 10.2-23.6) hours from incubation to growth detection, 4.5 (IQR, 1.5-10.7) hours from detection to Gram stain, and 30.9 (IQR, 22.0-41.9) hours from detection to isolate identification. An 8.6-hour delay was related to off-hours operating of laboratories.Conclusions and RelevanceThe findings of this study suggest that the multistep process of blood culturing is not managed comprehensively in Israel, leading to poor clinical practices and delayed results.

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“…It is recommended that in the context of adding a second agent to β-lactams or carbapenems for CRE infections in pediatric patients, aminoglycosides if found to be susceptible are preferable over polymyxins. 17,19,27 The potential adverse effects associated with tigecycline use in children are nausea, vomiting, diarrhea, and acute pancreatitis. 8,22 In our study, despite similar side effects such as nausea and vomiting observed in only four patients, no severe adverse effects leading to antibiotic cessation were observed.…”

Section: Discussionmentioning

confidence: 99%

Tigecycline Usage for Severe Infections in the Pediatric Intensive Care Unit

Ersayoğlu,

Yazıcı Özkaya,

Özenen

et al. 2024

J Pediatr Infect Dis

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Objective To evaluate the effectiveness and safety of using tigecycline as a salvage therapy in critically ill children who did not respond to other antibiotics. Methods We conducted a retrospective cohort analysis that included children who received tigecycline for at least 48 hours and four doses during their pediatric intensive care unit admission. Demographic and clinical features of the subjects were evaluated through a comprehensive review of medical records. The effectiveness of tigecycline was assessed by thoroughly evaluating clinical and microbiological outcomes. Results During the study period, 72 pediatric patients with 88 episodes of infection received tigecycline according to antimicrobial susceptibility in 62.5% of cases and empirically in 37.5%. The median duration of tigecycline therapy was 10 days (range, 2–33 days). Klebsiella pneumoniae (n = 17, 30.9%) was the most frequently isolated pathogen, followed by Acinetobacter baumannii (n = 10, 18.1%). Ventilator-associated pneumonia was the most common infection (n = 29). Of the 55 isolated pathogens, 43 were multidrug-resistant (MDR), and 2 were extensively drug-resistant (XDR) gram-negative bacteria. Clinical response and microbiological clearance were achieved in 42 and 50.9% of episodes, respectively. The overall mortality was 40.9%, with an attributable mortality rate of 29.5%. Conclusion Tigecycline could be used as a salvage therapy for critically ill pediatric patients infected with MDR or XDR pathogens in the lack of alternative treatment options.

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VII centenario de la Universidad de Salamanca

Cited by 3 publications

References 0 publications

Efficacy of Ceftazidime-Avibactam Salvage Therapy in Patients With Infections Caused byKlebsiella pneumoniaeCarbapenemase–producingK. pneumoniae

Efficacy of Ceftazidime-Avibactam Salvage Therapy in Patients With Infections Caused byKlebsiella pneumoniaeCarbapenemase–producingK. pneumoniae

Analysis of Blood Culture Collection and Laboratory Processing Practices in Israel

Tigecycline Usage for Severe Infections in the Pediatric Intensive Care Unit

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