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ECC-4 Abstracts

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… These isolates demonstrated clearly higher ceftazidime MICs than CTX-M-3 producers, which was also observed when the transconjugants were compared. … This data, together with other recent findings, demonstrate the danger of the use of ceftazidime against CTX-M-producing strains. …

Predominance of Non-carbapenemase Producing Carbapenem-Resistant Enterobacterales in South Texas.

BackgroundCarbapenem-resistant Enterobacterales (CRE) pose a significant global public health threat. Resistance among CRE is particularly complex, owing to numerous possible resistance mechanisms and broad definitions. We aimed to characterize the clinical and molecular profiles of CRE in the South Texas region.Materials and methodsWe compared the clinical, genotypic, and phenotypic profiles of carbapenemase producing Enterobacterales (CPE) with those of non-carbapenemase producers (NCPE) isolated from South Texas, United States between 2011 and 2019. Molecular characteristics and resistance

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… No molecular tests were used at time of clinical care; susceptibility patterns displayed resistance to carbapenems and ceftazidime-avibactam but susceptible to tigecycline. … Colistin versus ceftazidime-avibactam in the treatment of infections due to carbapenem-resistant Enterobacteriaceae. Clin. Infect. Dis. 66 163 – 171 . 10.1093/cid/cix783 29020404 PMC5850032 WHO ( 2020 ). …

Continuous non-invasive monitoring of the skin temperature of HSCT recipients.

Goals of workEmpirical antibiotic therapy usually started in patients who are neutropenic following treatment with cytostatic chemotherapy for a haematological malignancy as soon as fever develops to forestall fulminant sepsis. Hence, accurate and timely detection of fever is crucial to the successful management of infectious complications in these patients. We report an investigation of the feasibility and validity of continuous non-invasive body temperature measurement.Patients and methodsThe feasibility of non-invasive continuous measurement of the skin temperature was investigated using th

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… At the onset of fever, blood was obtained for cultures, ceftazidime was administered empirically, and the attending physician was alerted. … Ciuraru NB Braunstein R Sulkes A Stemmer SM The influence of mucositis on oral thermometry: when fever may not reflect infection Clin Infect Dis 2008 46 12 1859 1863 10.1086/588290 18462172 2. de Pauw BE Deresinski SC Feld R Lane-Allman EF Donnelly JP Ceftazidime compared with piperacillin and tobramycin …

Abstracts cont.

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… At 8 mg/L, 71.6/78.3% EU and US, respectively PA isolates were inhibited by BPR, compared to 76.5/79.8% for ceftazidime. The two drugs exhibited a high degree of cross-resistance. … For Gram-negative bacilli, the most effective antibiotics were amikacin (for E. coli) , tobramycin (for P. mirabilis) , cefotaxime (for K. pneumoniae) and ceftazidime (for P. vulgaris and E. cloacae). …

[Chinese expert consensus on the management of lower respiratory tract infections of Pseudomonas aeruginosa in adults(2022)].

Pseudomonas aeruginosa (PA) is the second common Gram-negative bacterium for hospital acquired pneumonia (HAP) in China (16.9%-22.0%). The p … -treat resistance PA (DTR-PA), if an agent of new enzyme inhibitor, such as ceftolozane/tazobactam, ceftazidime/avibactam, and imipenem/cilastatin/relebactam shows in vitro sensitivity, it is recommended as the first-line choice; cefiderocol may serve as the second-line treatment. Combination therapy based on polymyxins may also be considered. Other potential …

Impact of Adding a Rapid PCR-Based Blood Culture Identification Panel to the Antimicrobial Stewardship Program of Patients with Febrile Neutropenia in a Peruvian Referral Hospital.

The addition of Biofire® FilmArray® Blood Culture Identification panel 2 (BCID2) to the antimicrobial stewardship program (ASP) could improve outcomes in bloodstream infections (BSI) of patients with febrile neutropenia (FN). A pre- and post-quasi-experimental single-center study was conducted at a reference hospital in Peru. Three groups were considered: patients with BSI before ASP intervention (control group), patients with BSI after ASP intervention (group 1), and patients with BSI after ASP intervention plus BCID2 PCR Panel implementation (group 2). Overall, 93 patients were identified (3

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… The ATLAS global surveillance program from 2017 to 2019 collected information from the Latin American region and reported in vitro susceptibility to ceftazidime/avibactam and colistin in 99.4% and 74.9% in non-metallo-ẞ-lactamase CPE (n = 358), respectively [ 39 ]. … The place of ceftazidime/avibactam and ceftolozane/tazobactam for therapy of haematological patients with febrile neutropenia. Int. J. Antimicrob. Agents. 2021;57:106335. doi: 10.1016/j.ijantimicag.2021.106335. 39. …

Infections Caused by Acinetobacter baumannii in Recipients of Hematopoietic Stem Cell Transplantation.

Acinetobacter baumannii (A. baumannii) is a Gram-negative, strictly aerobic, non-fermentative coccobacillus, which is widely distributed in nature. Recently, it has emerged as a major cause of health care-associated infections (HCAIs) in addition to its capacity to cause community-acquired infections. Risk factors for A. baumannii infections and bacteremia in recipients of hematopoietic stem cell transplantation include: severe underlying illness such as hematological malignancy, prolonged use of broad-spectrum antibiotics, invasive instrumentation such as central venous catheters or endotrach

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… The most effective drugs in treating A. baumannii infections are: carbapenems such as imipenem and meropenem, β-lactam inhibitors such as ampicillin–sulbactam in addition to piperacillin–tazobactam and cephalosporins such as ceftazidime ( 1 , 3 , 6 , 8 , 9 ). … For community-acquired A. baumannii (CAAB) infections, the following antibiotics have been reported to be effective: cephalosporins such as ceftazidime, cefepime and cefpirome; carbapenems; aminoglycosides; and fluoroquinolones ( 3 ). …

Prophylaxis, diagnosis and therapy of infections in patients undergoing high-dose chemotherapy and autologous haematopoietic stem cell transplantation. 2020 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO).

To ensure the safety of high-dose chemotherapy and autologous stem cell transplantation (HDC/ASCT), evidence-based recommendations on infectious complications after HDC/ASCT are given. This guideline not only focuses on patients with haematological malignancies but also addresses the specifics of HDC/ASCT patients with solid tumours or autoimmune disorders. In addition to HBV and HCV, HEV screening is nowadays mandatory prior to ASCT. For patients with HBs antigen and/or anti-HBc antibody positivity, HBV nucleic acid testing is strongly recommended for 6 months after HDC/ASCT or for the durati

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… As there is no systematic data on the empiric use of doripenem [ 85 ], ceftazidime-avibactam [ 86 ], ceftolozane-tazobactam [ 87 ] or cefozopran [ 88 ] in this setting, they are not discussed here. … Antimicrobial activities of ceftazidime-avibactam and comparator agents against clinical bacteria isolated from patients with cancer. Antimicrob Agents Chemother. 2017;61(4):e02106–e02116. doi: 10.1128/AAC.02106-16. 87. …

Нетуберкулезные микобактерные инфекции в Центре комплексного рака Национального института рака во Флориде.

Нетуберкулезная микобактерия (НТМ) - это экологические организмы, которые становятся оппортунистическими патогенами в некоторых популяциях. Показатель распространенности НТМ возрос во всем мире, что, вероятно, объясняется расширением диагностических тестов и наличием демографических исследований. Нынешняя литература по онкологическим пациентам минимальна и представляет собой уникальную область исследований. Здесь мы представляем эпидемиологию и лечение случаев заражения НТМ в созданном Национальным институтом раковых заболеваний Центре комплексного лечения раковых заболеваний. Мы провели ретро

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… site | Pulmonary | Azithromycin, ethambutol, and rifabutin/rifampin | 18/34 (53) Extrapulmonary | Azithromycin, ceftaroline, meropenem, and tigecycline | 2/15 (13) Notable use for initial regimen | Carbapenem as part of dual β-lactam therapy | 9/49 (18) Imipenem-cilastatin (with ceftaroline or ceftazidime … event (1 drug change) | 8/49 (16) Tolerance issue (≥2 drug changes or therapy permanently held) | 22/49 (45) Efficacy/optimization issue | 16/49 (33) Notable use at any point during entire regimen | Carbapenem as part of dual β-lactam therapy e | 13/49 (27) Imipenem-cilastatin (with ceftaroline or ceftazidime …

Antimicrobial resistance phenotypes, disinfectant susceptibility, and resistance-associated gene detection in carbapenem-resistant Pseudomonas aeruginosa from two tertiary hospitals in Urumqi, China.

OBJECTIVE: To characterise antimicrobial resistance phenotypes, in vitro susceptibility to four commonly used disinfectants, and the distrib … ible to either agent. Overall resistance rates to aztreonam, piperacillin/tazobactam, levofloxacin, ceftazidime, cefepime, amikacin, and tobramycin were 37.50%, 30.00%, 26.30%, 25.00%, 21.30%, 12.50%, and 6.30% respectively. The expected oprD amplicon failed to amplify in 55 isolates (68.75%). mCIM was positive in 23 isolates (28.75%), with 95.0% agreement wi …

[Analysis of related factors of carbapenem resistant Klebsiella pneumoniae infection in patients with artificial airway].

OBJECTIVE: To analyze the clinical characteristics and related influencing factors of carbapenem resistant Klebsiella pneumoniae (CRKP) in p … d the lowest in 2018 (53.68%). The resistance rates of ceftetan, amikacin, piperacillin/tazobactam, ceftazidime, ceftriaxone and gentamicin in the study group were significantly higher than those in the control group (82.99% vs. 62.82%, 49.31% vs. 17.95%, 75.69% vs. 60.26%, 81.25% vs. 64.10%, 80.21% vs. 58.97%, 91.32% vs. 60.26%, all P < 0.05). Logistic regre …

Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible.

Data about short courses of antibiotic therapy for Gram-negative bacilli (GNB) bacteremia in immunosuppressed patients are limited. This is a prospective observational study performed on adult patients with cancer and hematopoietic stem cell transplant (HSCT) who developed GNB bacteremia and received appropriate empirical antibiotic therapy (EAT), had a clinical response within 7 days and survived 48 h after the end of therapy. They received antibiotic therapy in the range of 7-15 days and were divided into short course, with a median of 7 days (SC), or long course, with a median of 14 days (L

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… All the 5 KPC-CPE isolates in the SC group proved to be susceptible to ceftazidime-avibactam. The microbiological characteristics and resistance profiles of bacteremia episodes receiving SC and LC antibiotic therapy are described in Figure 1 , Figure 2 and Figure 3 . … Only patients under SC antibiotic therapy were prescribed ceftazidime-avibactam, and all of them received definitive treatment as monotherapy. In 11 (52.18%) of the 22 neutropenic patients in the SC group, antibiotic therapy was discontinued before neutrophil count recovery. …

Clinical and Genomic Epidemiology of Carbapenem-Nonsusceptible Citrobacter spp. at a Tertiary Health Care Center over 2 Decades.

Carbapenem-nonsusceptible Citrobacter spp. (CNSC) are increasingly recognized as health care-associated pathogens. Information regarding their clinical epidemiology, genetic diversity, and mechanisms of carbapenem resistance is lacking. We examined microbiology records of adult patients at the University of Pittsburgh Medical Center (UMPC) Presbyterian Hospital (PUH) from 2000 to 2018 for CNSC, as defined by ertapenem nonsusceptibility. Over this time frame, the proportion of CNSC increased from 4% to 10% (P = 0.03), as did daily defined carbapenem doses/1,000 patient days (6.52 to 34.5; R2 =

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… Next, we tested all 20 CNSC isolates against novel β-lactam–β-lactamase inhibitor agents and found that they were frequently susceptible to ceftazidime-avibactam (17/20 [85%]) and meropenem-vaborbactam (18/20 [90%]). … Isolate RS237 was also found to be resistant to ceftazidime-avibactam, even though its genome did not contain a carbapenemase sequence or evidence of porin mutations. …

Machine learning-based prognostic model for bloodstream infections in hematological malignancies using Th1/Th2 cytokines.

OBJECTIVE: Bloodstream infection (BSI) is a significant cause of mortality in patients with hematologic malignancies(HMs), particularly amid rising antibiotic resistance. This study aimed to analyze pathogen distribution, drug-resistance patterns and develop a novel predictive model for 30-day mortality in HM patients with BSIs. METHODS: A retrospective analysis of 231 HM patients with positive blood cultures was conducted. Logistic regression identified risk factors for 30-day mortality. Th1/Th2 cytokines were collected at BSI onset, with LASSO regression and restricted cubic spline analysis

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… Escherichia coli exhibited the highest resistance to ampicillin, cefotaxime, and ceftriaxone, with nearly 50% resistance to levofloxacin and 35.62% to ceftazidime. Klebsiella pneumoniae showed 24.53% resistance to meropenem and imipenem, 35.85% to ceftazidime, and 45.28% to piperacillin-tazobactam. … Pseudomonas aeruginosa demonstrated high resistance (89.47%) to ceftriaxone, cefotaxime, and tigecycline, while it remained sensitive to ceftazidime. No resistance to linezolid or vancomycin was detected in gram-positive bacteria; however, MRSA and MRCNS were identified [ 36 ]. …

Enteral versus parenteral nutrition in auto-HCT: a randomized controlled trial on clinical outcomes and gut microbiome dynamics.

Disruption of the gut microbiome is a common consequence of chemotherapy, linked with detrimental treatment outcomes (e.g. sepsis), especially in haematopoietic stem cell transplant (HCT) recipients. Preclinical data suggest that enteral nutrition (EN) is superior to parenteral nutrition (TPN), minimising gut atrophy and promoting eubiosis; yet, TPN continues to be used. Here, we evaluated the clinical effects of EN and TPN in autologous HCT recipients and their influence on gut microbiome dynamics. Despite efforts to optimise delivery, EN was poorly tolerated and ultimately proved unfeasible.

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… In case of fever during neutropenia, standard additional peripheral blood and CVC cultures were taken, and empirical monotherapy with ceftazidime 2000 mg TID was started [ 20 ]. … However, it is important to note that antibiotics were highly protocolised in this study, with empirical use restricted to ceftazidime—a third-generation antibiotic that is less active than first- and second-generation cephalosporins. …

Carbapenem Versus Non-carbapenem Therapy in Hematology Patients: Extended-Spectrum Beta-Lactamase Positive Enterobacteriaceae Colonization Impact.

BackgroundExtended-spectrum beta-lactamase-producing Enterobacteriacea (ESBL-E) infections are a major source of mortality and morbidity in patients with hematologic cancers. One of the most significant risk factors for bacterial illness is prior colonization with resistant germs. Empiric usage of carbapenems is recommended for the treatment of infections in patients with a positive colonization history.ObjectivesWe aimed to determine the outcome of empirical carbapenem (de-escalation) versus non-carbapenem (escalation) therapy in adult hematology patients who have rectal extended-spectrum bet

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… Confirmation of ESBL production was performed by Kirby-Bauer disc diffusion method and 30 µg ceftazidime versus 30/10 µg ceftazidime-clavulanate and 30 µg cefotaxime versus 30/10 µg cefotaxime-clavulanate discs were used for detection of ESBL enzyme according to the Clinical and Laboratory Standards …

Impact of vancomycin resistance on mortality in neutropenic patients with enterococcal bloodstream infection: a retrospective study.

BackgroundVancomycin-resistant Enterococcus (VRE) bloodstream infection (BSI) is generally associated with the delayed administration of adequate antibiotics. The identification of risk factors and outcomes of VRE BSI is necessary for establishing strategies for managing neutropenic fever in patients with hematological malignancies.MethodsWe retrospectively analysed consecutive cases of enterococcal BSI in patients with neutropenia after chemotherapy or stem cell transplantation between July 2009 and December 2011 at a single center.ResultsDuring the 30-month period, among 1,587 neutropenic pa

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… The initial empirical treatment of neutropenic fever in hematological malignancy patients is to use anti-pseudomonal cephalosporin (cefepime or ceftazidime) and/or an aminoglycoside (isepamicin), excluding the initial use of glycopeptides. … In their cohort, standard antibiotic therapy included ceftazidime, vancomycin, and often tobramycin until results of cultures were obtained, and such a strategy may have influenced the vancomycin resistance rate in enterococcal BSIs. …

The use of intravenous antibiotics at the onset of neutropenia in patients receiving outpatient-based hematopoietic stem cell transplants.

Empirical antibiotics at the onset of febrile neutropenia are one of several strategies for management of bacterial infections in patients undergoing Hematopoietic Stem Cell Transplant (HSCT) (empiric strategy). Our HSCT program aims to perform HSCT in an outpatient setting, where an empiric antibiotic strategy was employed. HSCT recipients began receiving intravenous antibiotics at the onset of neutropenia in the absence of fever as part of our institutional policy from 01 Jan 2009; intravenous Prophylactic strategy. A prospective study was conducted to compare two consecutive cohorts [Year 2

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… Australian and New Zealand Journal of Medicine 141 . 4 Avril M , Hartmann O , Valteau-Couanet D , Brugieres L , Kalifa C , et al ( 1994 ) Antiinfective prophylaxis with ceftazidime and teicoplanin in children undergoing high-dose chemotherapy and bone marrow transplantation . … Bone Marrow Transplant 45 : 1220 – 1226 . 19946343 10.1038/bmt.2009.330 23 Guthrie KA , Yong M , Frieze D , Corey L , Fredricks DN ( 2010 ) The impact of a change in antibacterial prophylaxis from ceftazidime to levofloxacin in allogeneic hematopoietic cell transplantation . …

Infectious Diseases

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… If neurosurgery/trauma, CSF shunt, or basilar skull fracture, give ceftazidime 2 g IV q8h plus vancomycin . … For Pseudomonas , piperacillin or carbapenem or ceftazidime, plus ciprofloxacin or aminoglycoside. Duration of therapy usually at least 6 weeks. …

Evaluation and Management of Bacterial and Fungal Infections Occurring in Patients with a Hematological Malignancy: A 2011 Update

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… Gastrointestinal mucositis, ceftazidime use, and prophylaxis with fluoroquinolones have been noted to be important risk factors for the development of these serious infections during periods of neutropenia. … These results are consistent with the findings published by Freifeld et al. who reported that fever persisted a mean of 4 days with ceftazidime therapy, and 3 days when patients were treated with imipenem [ 169 ]. …