Clinical effectiveness of cefiderocol for the treatment of bloodstream infections due to carbapenem-resistant Acinetobacter baumannii during the COVID-19 era : a single center, observational study
© 2024. The Author(s)..
BACKGROUND: We assessed the clinical effectiveness of cefiderocol (CFDC) in comparison with colistin (COL) for the treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections (BSI).
MATERIALS/METHODS: Retrospective cohort study including adults with CRAB-BSI. Outcomes were mortality, clinical cure and adverse events during therapy. The average treatment effect of CFDC compared to COL was weighted with the inverse-probability treatment weight (IPTW).
RESULTS: Overall, 104 patients were included (50 CFDC, 54 COL), median age 66.5 years, median Charlson Comorbidity Index 5, septic shock in 33.6% of patients. Primary BSI accounted for 43.3% of cases, followed by ventilator-associated pneumonia (VAP) (26%), catheter-related BSI (20.2%) and hospital-acquired pneumonia (HAP) (9.6%). Although not significantly, mortality at all time points was lower for CFDC than COL, while clinical cure was higher in CFDC than COL (66% vs. 44.4%, p = 0.027). Adverse events were more frequent in COL than CFDC-group (38.8% vs. 10%, p < 0.0001), primarily attributed to acute kidney injury (AKI) in the COL group. Patients with bacteremic HAP/VAP treated with CFDC had a significant lower 30-d mortality and higher clinical cure than COL (p = 0.008 and p = 0.0008, respectively). Increment of CCI (p = 0.005), ICU (p = 0.025), SARS-CoV2 (p = 0.006) and ECMO (p < 0.0001) were independently associated with 30-d mortality, while receiving CFDC was not associated with survival.
CONCLUSIONS: CFDC could represent an effective and safe treatment option for CRAB BSI, especially in patients with bacteremic HAP/VAP and frail patients where the risk of acute renal failure during therapy should be avoided.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology - (2024) vom: 18. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Oliva, Alessandra [VerfasserIn] |
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| Links: |
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| Themen: |
Bloodstream infection |
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| Anmerkungen: |
Date Revised 18.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s10096-024-04833-8 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM371240646 |
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| 100 | 1 | |a Oliva, Alessandra |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical effectiveness of cefiderocol for the treatment of bloodstream infections due to carbapenem-resistant Acinetobacter baumannii during the COVID-19 era |b a single center, observational study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 18.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a BACKGROUND: We assessed the clinical effectiveness of cefiderocol (CFDC) in comparison with colistin (COL) for the treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections (BSI) | ||
| 520 | |a MATERIALS/METHODS: Retrospective cohort study including adults with CRAB-BSI. Outcomes were mortality, clinical cure and adverse events during therapy. The average treatment effect of CFDC compared to COL was weighted with the inverse-probability treatment weight (IPTW) | ||
| 520 | |a RESULTS: Overall, 104 patients were included (50 CFDC, 54 COL), median age 66.5 years, median Charlson Comorbidity Index 5, septic shock in 33.6% of patients. Primary BSI accounted for 43.3% of cases, followed by ventilator-associated pneumonia (VAP) (26%), catheter-related BSI (20.2%) and hospital-acquired pneumonia (HAP) (9.6%). Although not significantly, mortality at all time points was lower for CFDC than COL, while clinical cure was higher in CFDC than COL (66% vs. 44.4%, p = 0.027). Adverse events were more frequent in COL than CFDC-group (38.8% vs. 10%, p < 0.0001), primarily attributed to acute kidney injury (AKI) in the COL group. Patients with bacteremic HAP/VAP treated with CFDC had a significant lower 30-d mortality and higher clinical cure than COL (p = 0.008 and p = 0.0008, respectively). Increment of CCI (p = 0.005), ICU (p = 0.025), SARS-CoV2 (p = 0.006) and ECMO (p < 0.0001) were independently associated with 30-d mortality, while receiving CFDC was not associated with survival | ||
| 520 | |a CONCLUSIONS: CFDC could represent an effective and safe treatment option for CRAB BSI, especially in patients with bacteremic HAP/VAP and frail patients where the risk of acute renal failure during therapy should be avoided | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bloodstream infection | |
| 650 | 4 | |a Carbapenem-resistant Acinetobacter baumannii | |
| 650 | 4 | |a Cefiderocol | |
| 650 | 4 | |a Colistin | |
| 650 | 4 | |a Pneumonia | |
| 650 | 4 | |a Ventilator-acquired pneumonia | |
| 700 | 1 | |a Liguori, L |e verfasserin |4 aut | |
| 700 | 1 | |a Covino, S |e verfasserin |4 aut | |
| 700 | 1 | |a Petrucci, F |e verfasserin |4 aut | |
| 700 | 1 | |a Cogliati-Dezza, F |e verfasserin |4 aut | |
| 700 | 1 | |a Curtolo, A |e verfasserin |4 aut | |
| 700 | 1 | |a Savelloni, G |e verfasserin |4 aut | |
| 700 | 1 | |a Comi, M |e verfasserin |4 aut | |
| 700 | 1 | |a Sacco, F |e verfasserin |4 aut | |
| 700 | 1 | |a Ceccarelli, G |e verfasserin |4 aut | |
| 700 | 1 | |a Viscido, A |e verfasserin |4 aut | |
| 700 | 1 | |a Alessandri, F |e verfasserin |4 aut | |
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| 700 | 1 | |a Pugliese, F |e verfasserin |4 aut | |
| 700 | 1 | |a Mastroianni, C M |e verfasserin |4 aut | |
| 700 | 1 | |a Venditti, M |e verfasserin |4 aut | |
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