A retrospective case-control study was conducted at Modena University Hospital from December 2017 to January 2019 to identify risk factors and predictors of MDR/XDR Pseudomonas aeruginosa (PA) isolation with resistance to ceftazidime/avibactam (CZA) and ceftolozane/tazobactam (C/T), and of mortality among patients infected/colonized. Among 111 PA isolates from clinical/surveillance samples, 60 (54.1%) were susceptible to both drugs (S-CZA-C/T), while 27 (24.3%) were resistant to both (R-CZA-C/T). Compared to patients colonized/infected with S-CZA-C/T, those with R-C/T+CZA PA had a statistically significantly higher Charlson comorbidity score, greater rate of previous PA colonization, longer time before PA isolation, more frequent presence of CVC, higher exposure to C/T and cephalosporins, longer hospital stay, and higher overall and attributable mortality. In the multivariable analysis, age, prior PA colonization, longer time from admission to PA isolation, diagnosis of urinary tract infection, and exposure to carbapenems were associated with the isolation of a R-C/T+CZA PA strain, while PA-related BSI, a comorbidity score > 7, and ICU stay were significantly associated with attributable mortality. C/T and CZA are important therapeutic resources for hard-to-treat PA-related infections, thus specific antimicrobial stewardship interventions should be prompted in order to avoid the development of this combined resistance, which would jeopardize the chance to treat these infections.

Combined resistance to ceftolozane-tazobactam and ceftazidime-avibactam in extensively drug-resistant (Xdr) and multidrug-resistant (mdr) pseudomonas aeruginosa: Resistance predictors and impact on clinical outcomes besides implications for antimicrobial stewardship programs / Meschiari, M.; Orlando, G.; Kaleci, S.; Bianco, V.; Sarti, M.; Venturelli, C.; Mussini, C.. - In: ANTIBIOTICS. - ISSN 2079-6382. - 10:10(2021), pp. 1-10. [10.3390/antibiotics10101224]

Combined resistance to ceftolozane-tazobactam and ceftazidime-avibactam in extensively drug-resistant (Xdr) and multidrug-resistant (mdr) pseudomonas aeruginosa: Resistance predictors and impact on clinical outcomes besides implications for antimicrobial stewardship programs

Meschiari M.;Orlando G.;Kaleci S.;Bianco V.;Mussini C.
2021

Abstract

A retrospective case-control study was conducted at Modena University Hospital from December 2017 to January 2019 to identify risk factors and predictors of MDR/XDR Pseudomonas aeruginosa (PA) isolation with resistance to ceftazidime/avibactam (CZA) and ceftolozane/tazobactam (C/T), and of mortality among patients infected/colonized. Among 111 PA isolates from clinical/surveillance samples, 60 (54.1%) were susceptible to both drugs (S-CZA-C/T), while 27 (24.3%) were resistant to both (R-CZA-C/T). Compared to patients colonized/infected with S-CZA-C/T, those with R-C/T+CZA PA had a statistically significantly higher Charlson comorbidity score, greater rate of previous PA colonization, longer time before PA isolation, more frequent presence of CVC, higher exposure to C/T and cephalosporins, longer hospital stay, and higher overall and attributable mortality. In the multivariable analysis, age, prior PA colonization, longer time from admission to PA isolation, diagnosis of urinary tract infection, and exposure to carbapenems were associated with the isolation of a R-C/T+CZA PA strain, while PA-related BSI, a comorbidity score > 7, and ICU stay were significantly associated with attributable mortality. C/T and CZA are important therapeutic resources for hard-to-treat PA-related infections, thus specific antimicrobial stewardship interventions should be prompted in order to avoid the development of this combined resistance, which would jeopardize the chance to treat these infections.
2021
10
10
1
10
Combined resistance to ceftolozane-tazobactam and ceftazidime-avibactam in extensively drug-resistant (Xdr) and multidrug-resistant (mdr) pseudomonas aeruginosa: Resistance predictors and impact on clinical outcomes besides implications for antimicrobial stewardship programs / Meschiari, M.; Orlando, G.; Kaleci, S.; Bianco, V.; Sarti, M.; Venturelli, C.; Mussini, C.. - In: ANTIBIOTICS. - ISSN 2079-6382. - 10:10(2021), pp. 1-10. [10.3390/antibiotics10101224]
Meschiari, M.; Orlando, G.; Kaleci, S.; Bianco, V.; Sarti, M.; Venturelli, C.; Mussini, C.
File in questo prodotto:
File Dimensione Formato  
2_antibiotics-10-01224.pdf

Open access

Tipologia: Versione pubblicata dall'editore
Dimensione 857.21 kB
Formato Adobe PDF
857.21 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1255218
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 3
social impact