dc.contributor.author | Stewart, Adam G. | |
dc.contributor.author | Paterson, David L. | |
dc.contributor.author | Young, Barnaby | |
dc.contributor.author | Lye, David C. | |
dc.contributor.author | Davis, Joshua S. | |
dc.contributor.author | Schneider, Kellie | |
dc.contributor.author | Yılmaz, Mesut | |
dc.contributor.author | Dinleyici, Rümeysa | |
dc.contributor.author | Runnegar, Naomi | |
dc.contributor.author | Henderson, Andrew | |
dc.contributor.author | Archuleta, Sophia | |
dc.contributor.author | Kalimuddin, Shirin | |
dc.contributor.author | Forde, Brian M. | |
dc.contributor.author | Chatfield, Mark D. | |
dc.contributor.author | Bauer, Michelle J. | |
dc.contributor.author | Lipman, Jeffrey | |
dc.contributor.author | Harris-Brown, Tiffany | |
dc.contributor.author | Harris, Patrick N. A. | |
dc.date.accessioned | 2021-11-29T06:13:05Z | |
dc.date.available | 2021-11-29T06:13:05Z | |
dc.date.issued | 2021 | en_US |
dc.identifier.citation | Stewart, A. G., Paterson, D. L., Young, B., Lye, D. C., Davis, J. S., Schneider, K. ... Harris, P. N. A. (2021). Meropenem versus piperacillin-tazobactam for definitive treatment of bloodstream ınfections caused by AmpC beta-lactamase-producing enterobacter spp, citrobacter freundii, morganella morganii, providencia spp, or serratia marcescens: A pilot multicenter randomized controlled trial (MERINO-2). Open Forum Infectious Diseases, 8(8). https://dx.doi.org/10.1093/ofid/ofab387 | en_US |
dc.identifier.issn | 2328-8957 | |
dc.identifier.uri | https://dx.doi.org/10.1093/ofid/ofab387 | |
dc.identifier.uri | https://hdl.handle.net/20.500.12511/8580 | |
dc.description.abstract | Background: Carbapenems are recommended treatment for serious infections caused by AmpC-producing gram-negative bacteria but can select for carbapenem resistance. Piperacillin-tazobactam may be a suitable alternative. Methods: We enrolled adult patients with bloodstream infection due to chromosomal AmpC producers in a multicenter randomized controlled trial. Patients were assigned 1:1 to receive piperacillin-tazobactam 4.5 g every 6 hours or meropenem 1 g every 8 hours. The primary efficacy outcome was a composite of death, clinical failure, microbiological failure, and microbiological relapse at 30 days. Results: Seventy-two patients underwent randomization and were included in the primary analysis population. Eleven of 38 patients (29%) randomized to piperacillin-tazobactam met the primary outcome compared with 7 of 34 patients (21%) in the meropenem group (risk difference, 8% [95% confidence interval {CI},-12% to 28%]). Effects were consistent in an analysis of the per-protocol population. Within the subcomponents of the primary outcome, 5 of 38 (13%) experienced microbiological failure in the piperacillin-tazobactam group compared to 0 of 34 patients (0%) in the meropenem group (risk difference, 13% [95% CI, 2% to 24%]). In contrast, 0% vs 9% of microbiological relapses were seen in the piperacillin-tazobactam and meropenem arms, respectively. Susceptibility to piperacillin-tazobactam and meropenem using broth microdilution was found in 96.5% and 100% of isolates, respectively. The most common AmpC β-lactamase genes identified were blaCMY-2, blaDHA-17, blaCMH-3, and blaACT-17. No ESBL, OXA, or other carbapenemase genes were identified. Conclusions: Among patients with bloodstream infection due to AmpC producers, piperacillin-tazobactam may lead to more microbiological failures, although fewer microbiological relapses were seen. Clinical Trials Registration: NCT02437045. | en_US |
dc.description.sponsorship | Royal Brisbane and Women's Hospital Foundation ; Pathology Queensland-Study, Education and Research Committee ; National Health and Medical Research Council of Australia | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Oxford University Press | en_US |
dc.rights | info:eu-repo/semantics/openAccess | en_US |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International | * |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Ampc β-Lactamase | en_US |
dc.subject | Carbapenem | en_US |
dc.subject | Clinical Trial | en_US |
dc.subject | Enterobacterales | en_US |
dc.subject | Piperacillin-Tazobactam | en_US |
dc.title | Meropenem versus piperacillin-tazobactam for definitive treatment of bloodstream infections caused by AmpC beta-lactamase-producing enterobacter spp, citrobacter freundii, morganella morganii, providencia spp, or serratia marcescens: A pilot multicenter randomized controlled trial (MERINO-2) | en_US |
dc.title.alternative | Meropenem versus piperacillin-tazobactam for definitive treatment of bloodstream infections caused by AmpC β-Lactamase–producing enterobacter spp, citrobacter freundii, morganella morganii, providencia spp, or serratia marcescens: A pilot multicenter randomized controlled trial (MERINO-2) | en_US |
dc.type | article | en_US |
dc.relation.ispartof | Open Forum 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 | 8 | en_US |
dc.identifier.issue | 8 | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | en_US |
dc.identifier.doi | 10.1093/ofid/ofab387 | en_US |
dc.identifier.wosquality | Q2 | en_US |
dc.identifier.scopusquality | Q1 | en_US |