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Войти в исследования Predictors of mortality and therapeutic efficacy in carbapenem-resistant Acinetobacter baumannii bacteremia.
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Russo Alessandro, Gullì Sara Palma, Vena Antonio, Spadafora Luigi, Bernardi Marco, Corcione Silvia, Ceccarelli Giancarlo, Alessandri Francesco, Mastroianni Claudio Maria, Oliva Alessandra, Venanzi Rullo Emmanuele, Caviglia Giuseppe, Cortegiani Andrea, Ippolito Mariachiara, Nunnari Giuseppe, Di Gennaro Francesco, Saracino Annalisa, Marino Andrea, Cacopardo Bruno, Tiseo Giusy, Falcone Marco, Galfo Valentina, Iaria Chiara, Pipitone Giuseppe, Cascio Antonio, Carbonara Sergio, Montemurro Laura, Serino Francesco Saverio, Boffa Nicoletta, Libanore Marco, De Rosa Francesco Giuseppe, Mattei Alessia, Calabresi Alessandra, Tumbarello Mario, Fontanelli Šuleková Lucia, Pallotto Carlo, Brugnaro Pierluigi, Mascianà Roberta, Tiri Beatrice, Coppola Nicola, Calabria Giosuele, Bandera Alessandra, Lombardi Andrea, Vassalini Paolo, Carannante Novella, Scaglione Vincenzo, Meschiari Marianna, Simonetti Omar, Mularoni Alessandra, Bar Fabrizio, Serraino Riccardo, Mussini Cristina, Bassetti Matteo, Biondi-Zoccai Giuseppe, Serapide Francesca, ITACA study group
Аннотация
METHODS: This was a prospective, observational, multicenter study conducted across 52 Italian centers. Over an 18-month period, adult hospitalized patients with CRAB bacteremia were enrolled.
RESULTS: Among 398 patients with CRAB bacteremia, sources were mainly CVC-related or primary, with 14- and 30-day mortality rates of 22% and 27% respectively. Cox regression analysis identified male sex (p=0.006), and chronic kidney disease (p=0.016) as independent predictors of 14-day mortality, while colistin-containing regimen (p=0.014), and cefiderocol-containing-regimen (p<0.001) were associated with 14-day survival; male sex (p=0.027), septic shock (p=0.018), previous colonization by A. baumannii (p<0.001), and tigecycline-containing regimen (p=0.021) were independent predictors of 30-day mortality, while cefiderocol-containing-regimen (p<0.001) was associated with 30-day survival. Propensity score matching revealed that cefiderocol was significantly associated with 14-day survival and clinical success. The combination of cefiderocol plus Fosfomycin was also significantly associated with clinical success.
CONCLUSION: Our findings highlight key clinical and therapeutic determinants of mortality and survival in patients with CRAB bacteraemia, providing valuable insights for improving the management of this challenging infection.