Geographical variation in therapy for bloodstream infections due to multidrug-resistant enterobacteriaceae: a post hoc analysis of the INCREMENT study
| العنوان: | Geographical variation in therapy for bloodstream infections due to multidrug-resistant enterobacteriaceae: a post hoc analysis of the INCREMENT study |
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| المؤلفون: | Patrick N.A. Harris, M. Diletta Pezzani, Belén Gutiérrez-Gutiérrez, Pierluigi Viale, Po-Ren Hsueh, Patricia Ruiz-Garbajosa, Mario Venditti, Mario Tumbarello, Carolina Navarro-Francisco, Esther Calbo, Murat Akova, Helen Giamarellou, Antonio Oliver, Benito Almirante, Oriol Gasch, Luis Martínez-Martínez, Mitchell J. Schwaber, George Daikos, Johann Pitout, Carmen Peña, Alicia Hernández-Torres, Yohei Doi, Federico Pérez, Felipe Francisco Tuon, Evelina Tacconelli, Yehuda Carmeli, Robert A. Bonomo, Álvaro Pascual, David L. Paterson, Jesús Rodríguez-Baño, M.D. del Toro, J. Gálvez, M. Falcone, A. Russob, I. Karaiskos, E.M. Trecarichi, A.R. Losito, E. García-Vázquez, J. Gómez, E. Roilides, E. Iosifidis, S. Pournaras, N. Prim, F. Navarro, B. Mirelis, J. Origüen, R. San Juan, M. Fernández-Ruiz, M. Almela, C. de la Calle, J.A. Martínez, L. Morata, N. Larrosa, M. Puig-Asensio, G. Bou, J. Molina, V. González, J. Bermejo, V. Rucci, E. Ruiz de Gopegui, C.I. Marinescu, M.C. Fariñas, M.E. Cano, M. Gozalo, J.R. Paño-Pardo, Marta Mora-Rillo, S. Gómez-Zorrilla, F. Tubau, A. Tsakris, O. Zarkotou, A. Antoniadou, G. Poulakou, M. Souli, W. Lowman, D. Virmani, Julian Torre-Cisneros, I. Machuca, Irene Gracia-Ahufinger, Ö.K. Azap, Ö. Helvaci, A.O. Sahin, R. Cantón, V. Pintado, M. Bartoletti, M. Giannella, S. Peter, A. Hamprecht, C. Badia, M. Xercavins, D. Fontanals, E. Jové |
| المساهمون: | Universidad de Cantabria, Harris, Patrick N.A., Pezzani, M. Diletta, Gutiérrez-Gutiérrez, Belén, Viale, Pierluigi, Hsueh, Po-Ren, Ruiz-Garbajosa, Patricia, Venditti, Mario, Tumbarello, Mario, Navarro-Francisco, Carolina, Calbo, Esther, Akova, Murat, Giamarellou, Helen, Oliver, Antonio, Almirante, Benito, Gasch, Oriol, Martínez-Martínez, Lui, Schwaber, Mitchell J., Daikos, George, Pitout, Johann, Peña, Carmen, Hernández-Torres, Alicia, Doi, Yohei, Pérez, Federico, Tuon, Felipe Francisco, Tacconelli, Evelina, Carmeli, Yehuda, Bonomo, Robert A., Pascual, Álvaro, Paterson, David L., Rodríguez-Baño, Jesú, del Toro, M.D., Gálvez, J., Falcone, M., Russo, A., Karaiskos, I., Trecarichi, E.M., Losito, A.R., García-Vázquez, E., Gómez, J., Roilides, E., Iosifidis, E., Pournaras, S., Prim, N., Navarro, F., Mirelis, B., Origüen, J., Juan, R. San, Fernández-Ruiz, M., Almela, M., de la Calle, C., Martínez, J.A., Morata, L., Larrosa, N., Puig-Asensio, M., Bou, G., Molina, J., González, V., Bermejo, J., Rucci, V., de Gopegui, E. Ruiz, Marinescu, C.I., Fariñas, M.C., Cano, M.E., Gozalo, M., Paño-Pardo, J.R., Mora-Rillo, Marta, Gómez-Zorrilla, S., Tubau, F., Tsakris, A., Zarkotou, O., Antoniadou, A., Poulakou, G., Souli, M., Lowman, W., Virmani, D., Torre-Cisneros, Julian, Machuca, I., Gracia-Ahufinger, Irene, Azap, Ã .K., Helvaci, Ã ., Sahin, A.O., Cantón, R., Pintado, V., Bartoletti, M., Giannella, M., Peter, S., Hamprecht, A., Badia, C., Xercavins, M., Fontanals, D., Jové, E. |
| المصدر: | Int J Antimicrob Agents. 2017 Nov;50(5):664-672 UCrea Repositorio Abierto de la Universidad de Cantabria Universidad de Cantabria (UC) |
| بيانات النشر: | Elsevier, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, 0301 basic medicine, Carbapenem, Global Health, Logistic regression, 0302 clinical medicine, Drug Resistance, Multiple, Bacterial, Antimicrobial stewardship, Pharmacology (medical), 030212 general & internal medicine, Aged, 80 and over, Enterobacteriaceae Infections, General Medicine, Middle Aged, Extended-spectrum beta-lactamase, Klebsiella pneumoniae, Infectious Diseases, Beta-lactam/beta-lactamase inhibitors, Female, beta-Lactamase Inhibitors, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, Combination therapy, β-Lactam/β-lactamase inhibitor, 030106 microbiology, Infectious Disease, Biology, beta-Lactams, Carbapenemase, 03 medical and health sciences, Extended-spectrum β-lactamase, Enterobacteriaceae, Sepsis, Post-hoc analysis, medicine, Escherichia coli, Humans, Aged, Retrospective Studies, Carbapenems, β-Lactam/β-lactamase inhibitor, Odds ratio, biochemical phenomena, metabolism, and nutrition, Extended-spectrum β-lactamase, Surgery, Multiple drug resistance, Observational study, Demography |
| الوصف: | We aimed to describe regional differences in therapy for bloodstream infection (BSI) caused by extended-spectrum ?-lactamase-producing Enterobacteriaceae (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE). 1,482 patients in 12 countries were included from an observational study of BSI caused by ESBL-E or CPE. Multivariate logistic regression was used to calculate adjusted odds ratios (aORs) for the influence of country of recruitment on empirical use of ?-lactam/?-lactamase inhibitors (BLBLI) or carbapenems, targeted use of BLBLI for ESBL-E and use of targeted combination therapy for CPE. The use of BLBLI for empirical therapy was least likely in sites from Israel (aOR 0.34, 95% CI 0.14-0.81), Greece (aOR 0.49, 95% CI 0.26-0.94) and Canada (aOR 0.31, 95% CI 0.11-0.88) but more likely in Italy (aOR 1.58, 95% CI 1.11-2.2) and Turkey (aOR 2.09, 95% CI 1.14-3.81), compared to Spain as a reference. Empirical carbapenems were more likely to be used in sites from Taiwan (aOR 1.73, 95% CI 1.03-2.92) and USA (aOR 1.89; 95% CI 1.05-3.39), and less likely in Italy (aOR 0.44, 95% CI 0.28-0.69) and Canada (aOR 0.10, 95% CI 0.01-0.74). Targeted BLBLI for ESBL-E was more likely in sites from Italy. Treatment at sites within Israel, Taiwan, Turkey and Brazil was associated with less combination therapy for CPE. Although this study does not provide precise data on the relative prevalence of ESBL-E or CPE, significant variation in therapy exists across countries even after adjustment for patient factors. A better understanding of what influences therapeutic choices for these infections will aid antimicrobial stewardship efforts. PH is supported by an Australian Postgraduate Award from the University of Queensland. The study was funded by the Ministerio de Economía y Competitividad, Instituto de Salud Carlos III - co-financed by European Development Regional Fund "A way to achieve Europe" ERDF, Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015). BGG, JRB, APH and YC also received funds from the COMBACTE-CARE project (grant agreement 115620), Innovative Medicines Initiative (IMI), the European Union's Seventh Framework Programme (FP7/2007-2013) and in-kind contributions from EFPIA companies. |
| وصف الملف: | STAMPA |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::634852c840d39c70d001361ea2a480b5Test http://hdl.handle.net/10902/11854Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....634852c840d39c70d001361ea2a480b5 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |