Sistema de Salut de Catalunya
Institut Català de la Salut
[Ferrer R] Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Fariñas MC] Hospital Marqués de Valdecilla, Santander, Spain. [Maseda E] Hospital Universitario La Paz, Madrid, Spain. [Salavert M] Hospital Universitario y Politécnico La Fe, Valencia, Spain. [Bou G] Hospital Universitario A Coruña, La Coruña, Spain. [Díaz-Regañón J] MSD, Madrid, Spain
Vall d'Hebron Barcelona Hospital Campus
2022-03-14T13:07:34Z
2022-03-14T13:07:34Z
2021-12
Carbapenemasa; Infeccions gramnegatives; Infeccions associades a l'assistència sanitària
Carbapenemasa; Infecciones gramnegativas; Infecciones asociadas a la asistencia sanitaria
Carbapenemase; Gram-negative infections; Healthcare-associated infections
Introduction. Carbapenem-resistant Gram-negative (CRGN) infections are a major public health problem in Spain, often implicated in complicated, healthcare-associated infections that require the use of potentially toxic antibacterial agents of last resort. The objective of this study was to assess the clinical management of complicated infections caused by CRGN bacteria in Spanish hospitals. Methods. The study included: 1) a survey assessing the GN infection and antibacterial susceptibility profile in five participating Spanish hospitals and 2) a non-interventional, retrospective single cohort chart review of 100 patients with complicated urinary tract infection (cUTI), complicated intra-abdominal infection (cIAI), or hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia (HABP/VABP) attributable to CRGN pathogens. Results. In the participating hospitals CRGN prevalence was 9.3% amongst complicated infections. In the retrospective cohort, 92% of infections were healthcare-associated, and Klebsiella pneumoniae and Pseudomonas aeruginosa were the most common pathogens. OXA was the most frequently detected carbapenemase type (71.4%). We found that carbapenems were frequently used to treat cUTI, cIAI, HABP/VABP caused by CRGN pathogens. Carbapenem use, particularly in combination with other agents, persisted after confirmation of carbapenem resistance. Clinical cure was 66.0%, mortality during hospitalization 35.0%, mortality at the time of chart review 62.0%, and 6-months-post-discharge readmission 47.7%. Conclusion. Our results reflect the high burden and unmet needs associated with the management of complicated infections attributable to CRGN pathogens in Spain and highlight the urgent need for enhanced clinical management of these difficult-to-treat infections.
Funding for this research was provided by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.
Article
Published version
English
Malalties bacterianes gramnegatives - Tractament; Respiració artificial; Infeccions nosocomials; DISEASES::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections; DISEASES::Bacterial Infections and Mycoses::Infection::Cross Infection; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Equipment and Supplies::Ventilators, Mechanical; Other subheadings::Other subheadings::Other subheadings::/adverse effects; ENFERMEDADES::infecciones bacterianas y micosis::infecciones bacterianas::infecciones por bacterias gramnegativas; ENFERMEDADES::infecciones bacterianas y micosis::infección::infección hospitalaria; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::equipos y suministros::ventiladores mecánicos; Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos
Sociedad Española de Quimioterapia
Revista Española de Quimioterapia;34(6)
http://www.doi.org/10.37201/req/096.2021
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
Articles científics - HVH [3439]
