Colistin Resistance Development Following Colistin-Meropenem Combination Therapy Versus Colistin Monotherapy in Patients With Infections Caused by Carbapenem-Resistant Organisms
| العنوان: | Colistin Resistance Development Following Colistin-Meropenem Combination Therapy Versus Colistin Monotherapy in Patients With Infections Caused by Carbapenem-Resistant Organisms |
|---|---|
| المؤلفون: | Yehuda Carmeli, Emanuele Durante-Mangoni, Leonard Leibovici, Anna Skiada, Jonathan Lellouche, Nadya Rakovitsky, Lena E. Friberg, Mical Paul, Dafna Yahav, Sergey Altunin, Anastasia Antoniadou, Amir Nutman, Mariano Bernardo, Yaakov Dickstein, Johan W. Mouton, Vered Daitch, Ioannis Deliolanis, Domenico Iossa, Yael Dishon Benattar, David Schwartz, George L. Daikos, Viktor Rognås |
| المساهمون: | Medical Microbiology & Infectious Diseases, Dickstein, Yaakov, Lellouche, Jonathan, Schwartz, David, Nutman, Amir, Rakovitsky, Nadya, Dishon Benattar, Yael, Altunin, Sergey, Bernardo, Mariano, Iossa, Domenico, Durante-Mangoni, Emanuele, Antoniadou, Anastasia, Skiada, Anna, Deliolanis, Ioanni, Daikos, George L, Daitch, Vered, Yahav, Dafna, Leibovici, Leonard, Rognås, Viktor, Friberg, Lena E, Mouton, Johan W, Paul, Mical, Carmeli, Yehuda |
| المصدر: | Clinical Infectious Diseases, 71(10), 2599-2607. Oxford University Press |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | 0301 basic medicine, Microbiology (medical), Carbapenem, medicine.medical_specialty, Infectious Medicine, Combination therapy, 030106 microbiology, Resistance, Infektionsmedicin, Microbial Sensitivity Tests, Meropenem, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Enterobacteriaceae, law, Internal medicine, Gram-Negative Bacteria, medicine, polycyclic compounds, Humans, 030212 general & internal medicine, biology, business.industry, Colistin, Incidence (epidemiology), Hazard ratio, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, bacterial infections and mycoses, Gram-negative, Anti-Bacterial Agents, Infectious Diseases, Carbapenems, bacteria, lipids (amino acids, peptides, and proteins), business, medicine.drug |
| الوصف: | Background We evaluated whether carbapenem-colistin combination therapy reduces the emergence of colistin resistance, compared to colistin monotherapy, when given to patients with infections due to carbapenem-resistant Gram-negative organisms. Methods This is a pre-planned analysis of a secondary outcome from a randomized, controlled trial comparing colistin monotherapy with colistin-meropenem combination for the treatment of severe infections caused by carbapenem-resistant, colistin-susceptible Gram-negative bacteria. We evaluated rectal swabs taken on Day 7 or later for the presence of new colistin-resistant (ColR) isolates. We evaluated the emergence of any ColR isolate and the emergence of ColR Enterobacteriaceae (ColR-E). Results Data were available for 214 patients for the primary analysis; emergent ColR organisms were detected in 22 (10.3%). No difference was observed between patients randomized to treatment with colistin monotherapy (10/106, 9.4%) versus patients randomized to colistin-meropenem combination therapy (12/108, 11.1%; P = .669). ColR-E organisms were detected in 18/249 (7.2%) patients available for analysis. No difference was observed between the 2 treatment arms (colistin monotherapy 6/128 [4.7%] vs combination therapy 12/121 [9.9%]; P = .111). Enterobacteriaceae, as the index isolate, was found to be associated with development of ColR-E (hazard ratio, 3.875; 95% confidence interval, 1.475–10.184; P = .006). Conclusions Carbapenem-colistin combination therapy did not reduce the incidence of colistin resistance emergence in patients with infections due to carbapenem-resistant organisms. Further studies are necessary to elucidate the development of colistin resistance and methods for its prevention. |
| تدمد: | 1537-6591 1058-4838 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2a94f7fd162437e0b4ce6361dd09565cTest https://pubmed.ncbi.nlm.nih.gov/31758195Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....2a94f7fd162437e0b4ce6361dd09565c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15376591 10584838 |
|---|