Multicenter study on clinical outcomes and risk factors in patients with Klebsiella pneumoniae bacteremia receiving cefoperazone/sulbactam treatment
Abstract Background Infections caused by Klebsiella pneumoniae are common and result in high mortality rates. In vitro studies demonstrated the potency of cefoperazone/sulbactam (CPZ/SUL) against Klebsiella pneumoniae. However, the clinical efficacy of CPZ/SUL for the treatment of K. pneumoniae bacteremia has not been studied. Objectives This study aimed to correlate the clinical outcomes of patients with bacteremia with the minimal inhibitory concentrations (MICs) of CPZ/SUL against the causative K. pneumoniae isolates. Methods This multicenter, retrospective observational study was conducted in Taiwan between July 2017 and April 2021. Patients with K. pneumoniae bacteremia treated with CPZ/SUL were enrolled in this study. CPZ/SUL MICs were determined using the agar dilution method. Data on the patients’ clinical outcomes and characteristics were collected and analyzed. Results In total, 201 patients were enrolled. Among the causative K. pneumoniae isolates, 180 (89.5%) were susceptible to CPZ/SUL. Most patients (n = 156, 77.6%) had favorable outcomes. The 30-day mortality rate was 11.9% (n = 24). Multivariate risk analyses showed that higher APACHE II score (Odds Ratio (OR), 1.14; Confidence Interval (CI), 1.07–1.21; p < 0.001), metastatic tumors (OR, 5.76; CI, 2.31–14.40; p < 0.001), and causative K. pneumoniae CPZ/SUL MICs > 16 µg/ml (OR, 4.30; CI, 1.50–12.27; p = 0.006) were independently associated with unfavorable outcomes. Conclusion Patients with K. pneumoniae bacteremia treated with CPZ/SUL at a ratio 1:1 had favorable outcomes when the CPZ/SUL MICs were ≤ 16 µg/ml. Patients with higher APACHE II scores and metastatic tumors had unfavorable outcomes..
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Preprint| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
ResearchSquare.com - (2024) vom: 28. Feb. Zur Gesamtaufnahme - year:2024 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chiang, Tsung-Ta [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| Themen: |
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| doi: |
10.21203/rs.3.rs-3982160/v1 |
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| PPN (Katalog-ID): |
XRA042666619 |
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| 520 | |a Abstract Background Infections caused by Klebsiella pneumoniae are common and result in high mortality rates. In vitro studies demonstrated the potency of cefoperazone/sulbactam (CPZ/SUL) against Klebsiella pneumoniae. However, the clinical efficacy of CPZ/SUL for the treatment of K. pneumoniae bacteremia has not been studied. Objectives This study aimed to correlate the clinical outcomes of patients with bacteremia with the minimal inhibitory concentrations (MICs) of CPZ/SUL against the causative K. pneumoniae isolates. Methods This multicenter, retrospective observational study was conducted in Taiwan between July 2017 and April 2021. Patients with K. pneumoniae bacteremia treated with CPZ/SUL were enrolled in this study. CPZ/SUL MICs were determined using the agar dilution method. Data on the patients’ clinical outcomes and characteristics were collected and analyzed. Results In total, 201 patients were enrolled. Among the causative K. pneumoniae isolates, 180 (89.5%) were susceptible to CPZ/SUL. Most patients (n = 156, 77.6%) had favorable outcomes. The 30-day mortality rate was 11.9% (n = 24). Multivariate risk analyses showed that higher APACHE II score (Odds Ratio (OR), 1.14; Confidence Interval (CI), 1.07–1.21; p < 0.001), metastatic tumors (OR, 5.76; CI, 2.31–14.40; p < 0.001), and causative K. pneumoniae CPZ/SUL MICs > 16 µg/ml (OR, 4.30; CI, 1.50–12.27; p = 0.006) were independently associated with unfavorable outcomes. Conclusion Patients with K. pneumoniae bacteremia treated with CPZ/SUL at a ratio 1:1 had favorable outcomes when the CPZ/SUL MICs were ≤ 16 µg/ml. Patients with higher APACHE II scores and metastatic tumors had unfavorable outcomes. | ||
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| 700 | 1 | |a Tang, Hung-Jen |4 aut | |
| 700 | 1 | |a Shi, Zhi-Yuan |4 aut | |
| 700 | 1 | |a Ho, Mao-Wang |4 aut | |
| 700 | 1 | |a Chou, Chia-Hui |4 aut | |
| 700 | 1 | |a Lin, Shang-Yi |4 aut | |
| 700 | 1 | |a Lu, Po-Liang |4 aut | |
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| 700 | 1 | |a Shie, Shian-Sen |4 aut | |
| 700 | 1 | |a Liu, Jien-Wei |4 aut | |
| 700 | 1 | |a Chang, Feng-Yee |4 aut | |
| 700 | 1 | |a Chuang, Yin-Ching |4 aut | |
| 700 | 1 | |a Wang, Fu-Der |4 aut | |
| 700 | 1 | |a Yang, Ya-Sung |4 aut | |
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