Treatment and clinical outcomes of urinary tract infections caused by KPC-producing Enterobacteriaceae in a retrospective cohort.
Treatment and clinical outcomes of urinary tract infections caused by KPC-producing Enterobacteriaceae in a retrospective cohort.
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DOI：
10.1016/j.clinthera.2012.05.002
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发表时间：
2012-06
影响因子：
3.2
通讯作者：
Ritchie DJ
中科院分区：
文献类型：
--
作者：
Alexander BT;Marschall J;Tibbetts RJ;Neuner EA;Dunne WM Jr;Ritchie DJ
Optimal treatment regimens for infections caused by Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae are not well defined. This study describes the treatment and outcomes of patients with urinary tract infection (UTI) caused by KPC-producing Enterobacteriaceae. Retrospective cohort study of adult inpatients with bacteriuria caused by KPC-positive organisms at Barnes-Jewish Hospital from June 1, 2006 to February 1, 2008. KPC-positive isolates were identified utilizing disk diffusion susceptibility testing and confirmed to contain blaKPC via molecular methods. Twenty-one patients met inclusion criteria and all were classified as having symptomatic UTI. The majority of patients were female (15 of 21 – 71%) with a mean age of 62.4 years (SD ± 15.2). Successful clinical and microbiologic responses were observed in 16 patients (76%) for both outcomes. Patients with urinary catheters had them removed or replaced in 9 of 15 cases (60%). Antibiotics active against the isolated pathogen were provided in 14 of 21 cases (67%), often after considerable delay (median: 72.5 hours, range: 4–312 hours). All seven patients receiving aminoglycoside therapy had successful clinical and microbiological responses, and in vitro testing of an extended antibiotic panel revealed high susceptibility rates for tigecycline (28 of 29 – 97%), minocycline (22 of 29 – 76%), and fosfomycin (25 of 29 – 86%) against the KPC-positive isolates. Although delays to receipt of appropriate therapy were often experienced, clinical outcomes investigated revealed high rates of successful response in this limited group of patients. Therapy with aminoglycosides and tetracycline derivatives suggest therapeutic promise in the treatment of KPC-producing Enterobacteriaceae UTI.
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影响因子：
5.2
作者：
Poulou, Aggeliki;Spanakis, Nicholas;Tsakris, Athanassios
通讯作者：
Tsakris, Athanassios
影响因子：
4.9
作者：
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通讯作者：
Bonomo, Robert A.
DOI：
10.1016/j.ijantimicag.2009.10.019
发表时间：
2010-03-01
影响因子：
10.8
作者：
Falagas, Matthew E.;Maraki, Sofia;Samonis, George
通讯作者：
Samonis, George
影响因子：
4.9
作者：
Endimiani, Andrea;Patel, Gopi;Bonomo, Robert A.
通讯作者：
Bonomo, Robert A.
影响因子：
4.5
作者：
Gasink LB;Edelstein PH;Lautenbach E;Synnestvedt M;Fishman NO
通讯作者：
Fishman NO