dc.contributor.author | Henderson, A. | |
dc.contributor.author | Paterson, D. L. | |
dc.contributor.author | Chatfield, M. D. | |
dc.contributor.author | Tambyah, P. A. | |
dc.contributor.author | Lye, D. C. | |
dc.contributor.author | De, P. P. | |
dc.contributor.author | Lin, R. T. P. | |
dc.contributor.author | Chew, K. L. | |
dc.contributor.author | Yin, M. | |
dc.contributor.author | Lee, T. H. | |
dc.contributor.author | Yılmaz, Mesut | |
dc.contributor.author | Çakmak, Rümeysa | |
dc.contributor.author | Alenazi, T. H. | |
dc.contributor.author | Arabi, Y. M | |
dc.contributor.author | Falcone, M. | |
dc.contributor.author | Bassetti, M. | |
dc.contributor.author | Righi, E. | |
dc.contributor.author | Ba, Rogers | |
dc.contributor.author | Kanj, S. S. | |
dc.contributor.author | Bhally, H. | |
dc.contributor.author | Iredell, J. | |
dc.contributor.author | Mendelson, M. | |
dc.contributor.author | Boyles, T. H. | |
dc.contributor.author | Looke, D. F. M. | |
dc.contributor.author | Runnegar, N. J. | |
dc.contributor.author | Miyakis, S. | |
dc.contributor.author | Walls, G. | |
dc.contributor.author | Ai Khamis, M. | |
dc.contributor.author | Zikri, A. | |
dc.contributor.author | Crowe, A. | |
dc.contributor.author | Ingram, P. R. | |
dc.contributor.author | Daneman, N. N. | |
dc.contributor.author | Griffin, P. | |
dc.contributor.author | Athan, E. | |
dc.contributor.author | Roberts, L. | |
dc.contributor.author | Beatson, S. A. | |
dc.contributor.author | Peleg, A. Y. | |
dc.contributor.author | Cottrell, K. K. | |
dc.contributor.author | Bauer, M. J. | |
dc.contributor.author | Tan, E. | |
dc.contributor.author | Chaw, K. | |
dc.contributor.author | Nimmo, G. R. | |
dc.contributor.author | Harris-Brown, T. | |
dc.contributor.author | Harris, P. N. A. | |
dc.date.accessioned | 2021-04-02T11:11:26Z | |
dc.date.available | 2021-04-02T11:11:26Z | |
dc.date.issued | 2021 | en_US |
dc.identifier.citation | Henderson, 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 | en_US |
dc.identifier.issn | 1058-4838 | |
dc.identifier.issn | 1537-6591 | |
dc.identifier.uri | https://doi.org/10.1093/cid/ciaa1479 | |
dc.identifier.uri | https://hdl.handle.net/20.500.12511/6678 | |
dc.description.abstract | Introduction: 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. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Oxford University Press | en_US |
dc.rights | info:eu-repo/semantics/closedAccess | en_US |
dc.subject | Piperacillin-Tazobactam | en_US |
dc.subject | Meropenem | en_US |
dc.subject | Extended Spectrum Beta-Lactamase | en_US |
dc.subject | Bloodstream Infection | en_US |
dc.title | Association between minimum inhibitory concentration, beta-lactamase genes and mortality for patients treated with piperacillin/tazobactam or meropenem from the MERINO study | en_US |
dc.type | article | en_US |
dc.relation.ispartof | Clinical Infectious Diseases | en_US |
dc.department | İstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı | en_US |
dc.authorid | 0000-0001-8022-7325 | en_US |
dc.authorid | 0000-0001-8930-741X | en_US |
dc.identifier.volume | 73 | en_US |
dc.identifier.issue | 11 | en_US |
dc.identifier.startpage | e3842 | en_US |
dc.identifier.endpage | e3850 | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | en_US |
dc.identifier.doi | 10.1093/cid/ciaa1479 | en_US |
dc.identifier.wosquality | Q1 | en_US |
dc.identifier.scopusquality | Q1 | en_US |