Association between minimum inhibitory concentration, beta-lactamase genes and mortality for patients treated with piperacillin/tazobactam or meropenem from the MERINO study

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dc.authorid0000-0001-8022-7325
dc.authorid0000-0001-8930-741X
dc.contributor.authorHenderson, A.
dc.contributor.authorPaterson, D. L.
dc.contributor.authorChatfield, M. D.
dc.contributor.authorTambyah, P. A.
dc.contributor.authorLye, D. C.
dc.contributor.authorDe, P. P.
dc.contributor.authorLin, R. T. P.
dc.contributor.authorChew, K. L.
dc.contributor.authorYin, M.
dc.contributor.authorLee, T. H.
dc.contributor.authorYılmaz, Mesut
dc.contributor.authorÇakmak, Rümeysa
dc.contributor.authorAlenazi, T. H.
dc.contributor.authorArabi, Y. M
dc.contributor.authorFalcone, M.
dc.contributor.authorBassetti, M.
dc.contributor.authorRighi, E.
dc.contributor.authorBa, Rogers
dc.contributor.authorKanj, S. S.
dc.contributor.authorBhally, H.
dc.contributor.authorIredell, J.
dc.contributor.authorMendelson, M.
dc.contributor.authorBoyles, T. H.
dc.contributor.authorLooke, D. F. M.
dc.contributor.authorRunnegar, N. J.
dc.contributor.authorMiyakis, S.
dc.contributor.authorWalls, G.
dc.contributor.authorAi Khamis, M.
dc.contributor.authorZikri, A.
dc.contributor.authorCrowe, A.
dc.contributor.authorIngram, P. R.
dc.contributor.authorDaneman, N. N.
dc.contributor.authorGriffin, P.
dc.contributor.authorAthan, E.
dc.contributor.authorRoberts, L.
dc.contributor.authorBeatson, S. A.
dc.contributor.authorPeleg, A. Y.
dc.contributor.authorCottrell, K. K.
dc.contributor.authorBauer, M. J.
dc.contributor.authorTan, E.
dc.contributor.authorChaw, K.
dc.contributor.authorNimmo, G. R.
dc.contributor.authorHarris-Brown, T.
dc.contributor.authorHarris, P. N. A.
dc.date.accessioned2021-04-02T11:11:26Z
dc.date.available2021-04-02T11:11:26Z
dc.date.issued2021
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
dc.description.abstractIntroduction: This study aims to assess the association of piperacillin/tazobactam and meropenem minimum inhibitory concentration (MIC) and beta-lactam resistance genes with mortality in the MERINO trial.Methods: Blood culture isolates from enrolled patients were tested by broth microdilution and whole genome sequencing at a central laboratory. Multivariate logistic regression was performed to account for confounders. Absolute risk increase for 30-day mortality between treatment groups was calculated for the primary analysis (PA) and the microbiologic assessable (MA) populations.Results: 320 isolates from 379 enrolled patients were available with susceptibility to piperacillin/tazobactam 94% and meropenem 100%. The piperacillin/tazobactam non-susceptible breakpoint (MIC > 16 mg/L) best predicted 30-day mortality after accounting for confounders (odds ratio 14.9, 95% CI 2.8 - 87.2). The absolute risk increase for 30-day mortality for patients treated with piperacillin/tazobactam compared with meropenem was 9% (95% CI 3% - 15%) and 8% (95% CI 2% - 15%) for the original PA population and the post-hoc MA populations, which reduced to 5% (95% CI -1% - 10%) after excluding strains with piperacillin/tazobactam MIC values > 16 mg/L. Isolates co-harboring ESBL and OXA-1 genes were associated with elevated piperacillin/tazobactam MICs and the highest risk increase in 30-mortality of 14% (95% CI 2% - 28%).Conclusion: After excluding non-susceptible strains, the 30-day mortality difference was from the MERINO trial was less pronounced for piperacillin/tazobactam. Poor reliability in susceptibility testing performance for piperacillin/tazobactam and the high prevalence of OXA co-harboring ESBLs suggests meropenem remains the preferred choice for definitive treatment of ceftriaxone non-susceptible E. coli and Klebsiella.
dc.identifier.citationHenderson, A., Paterson, D. L., Chatfield, M. D., Tambyah, P. A., Lye, D. C., De, P. P. ... Harris, P. N. A. (2021). Association between minimum inhibitory concentration, beta-lactamase genes and mortality for patients treated with piperacillin/tazobactam or meropenem from the MERINO study. Clinical Infectious Diseases, 73(11), e3842-e3850. https://doi.org/10.1093/cid/ciaa1479
dc.identifier.doi10.1093/cid/ciaa1479
dc.identifier.endpagee3850
dc.identifier.issn1058-4838
dc.identifier.issn1537-6591
dc.identifier.issue11
dc.identifier.scopusqualityQ1
dc.identifier.startpagee3842
dc.identifier.urihttps://doi.org/10.1093/cid/ciaa1479
dc.identifier.urihttps://hdl.handle.net/20.500.12511/6678
dc.identifier.volume73
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherOxford University Press
dc.relation.ispartofClinical Infectious Diseasesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectPiperacillin-Tazobactam
dc.subjectMeropenem
dc.subjectExtended Spectrum Beta-Lactamase
dc.subjectBloodstream Infection
dc.titleAssociation between minimum inhibitory concentration, beta-lactamase genes and mortality for patients treated with piperacillin/tazobactam or meropenem from the MERINO study
dc.typeArticle

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