Blood stream infections due to OXA-48-like carbapenemase-producing Enterobacteriaceae: treatment and survival

摘要: Summary Background Blood stream infections (BSIs) due to carbapenem-resistant Enterobacteriaceae (CRE) are associated with high hospital mortality rates and present a tremendous challenge clinicians. The optimal treatment remains undefined. We aimed investigate the risk factors for correlation between different modalities outcomes. Methods clinical characteristics outcomes of cohort 36 patients BSIs CRE were investigated retrospective nested case–control study surviving non-surviving was conducted. Results Fifty percent cases male mean patient age 54.9±15.8 years. Klebsiella pneumoniae etiological agent in 26 (72.2%), Escherichia coli eight (22.2%), Enterobacter aerogenes two (5.5%). All strains phenotypically positive carbapenemase activity all except (one E. one K. ) yielded both bla OXA-48 carbapenemases CTX-M-type extended-spectrum beta-lactamases (ESBLs) PCR products. 14-day, 28-day, all-cause in-hospital 41.6%, 50%, 58.3%, respectively. median time death 8 days (range 2–52 days). No significant differences observed survivors non-survivors terms baseline characteristics, comorbid conditions, etiologies, or sources bacteremia, however hematological malignancies ( p =0.015) prolonged neutropenia =0.044) more common non-survivors. Microbiological eradication response within 7 major determinants 28-day attributable =0.001 =0.001, adjusted r 2 =0.845). Colistin-based dual combinations, preferably triple significantly better when compared non-colistin-based regimens =0.014). Conclusion Earlier active colistin based microbiological wthin predictors survival CRE. Rectal screening offers advantage earlier recognition prompt empirical treatment.