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Oliva A, Volpicelli L, Di Bari S, Curtolo A, Borrazzo C, Cogliati Dezza F, Cona A, Agrenzano S, Mularoni A, Trancassini M, Mengoni F, Stefani S, Raponi G, Venditti M. Effect of ceftazidime/avibactam plus fosfomycin combination on 30 day mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae: results from a multicentre retrospective study. JAC Antimicrob Resist 2022; 4:dlac121. [PMID: 36506890 PMCID: PMC9728520 DOI: 10.1093/jacamr/dlac121] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 11/05/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction The primary outcome of the study was to evaluate the effect on 30 day mortality of the combination ceftazidime/avibactam + fosfomycin in the treatment of bloodstream infections (BSIs) caused by KPC-producing Klebsiella pneumoniae (KPC-Kp). Materials and methods From October 2018 to March 2021, a retrospective, two-centre study was performed on patients with KPC-Kp BSI hospitalized at Sapienza University (Rome) and ISMETT-IRCCS (Palermo) and treated with ceftazidime/avibactam-containing regimens. A matched cohort (1:1) analysis was performed. Cases were patients receiving ceftazidime/avibactam + fosfomycin and controls were patients receiving ceftazidime/avibactam alone or in combination with in vitro non-active drugs different from fosfomycin (ceftazidime/avibactam ± other). Patients were matched for age, Charlson comorbidity index, ward of isolation (ICU or non-ICU), source of infection and severity of BSI, expressed as INCREMENT carbapenemase-producing Enterobacteriaceae (CPE) score. Results Overall, 221 patients were included in the study. Following the 1:1 match, 122 subjects were retrieved: 61 cases (ceftazidime/avibactam + fosfomycin) and 61 controls (ceftazidime/avibactam ± other). No difference in overall mortality emerged between cases and controls, whereas controls had more non-BSI KPC-Kp infections and a higher number of deaths attributable to secondary infections. Almost half of ceftazidime/avibactam + fosfomycin patients were prescribed fosfomycin without MIC fosfomycin availability. No difference in the outcome emerged after stratification for fosfomycin susceptibility availability and dosage. SARS-CoV-2 infection and ICS ≥ 8 independently predicted 30 day mortality, whereas an appropriate definitive therapy was protective. Conclusions Our data show that fosfomycin was used in the treatment of KPC-Kp BSI independently from having its susceptibility testing available. Although no difference was found in 30 day overall mortality, ceftazidime/avibactam + fosfomycin was associated with a lower rate of subsequent KPC-Kp infections and secondary infections than other ceftazidime/avibactam-based regimens.
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Affiliation(s)
- A Oliva
- Corresponding author. E-mail:
| | | | - S Di Bari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - A Curtolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - C Borrazzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - F Cogliati Dezza
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - A Cona
- Unit of Infectious Diseases, ISMETT-IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Via E. Tricomi, 5, Palermo 90127, Italy
| | - S Agrenzano
- Unit of Infectious Diseases, ISMETT-IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Via E. Tricomi, 5, Palermo 90127, Italy
| | - A Mularoni
- Unit of Infectious Diseases, ISMETT-IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Via E. Tricomi, 5, Palermo 90127, Italy
| | - M Trancassini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - F Mengoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - S Stefani
- Department of Biomedical and Biotechnological Sciences. Policlinico Hospital, University of Catania, Via Androne 81, Catania 95124, Italy
| | - G Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
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Oliva A, Curtolo A, Volpicelli L, Cancelli F, Borrazzo C, Cogliati Dezza F, Marcelli G, Gavaruzzi F, Di Bari S, Ricci P, Turriziani O, Mastroianni CM, Venditti M. Correction: Clinical course of Coronavirus Disease-19 in patients with haematological malignancies is characterized by a longer time to respiratory deterioration compared to non-haematological ones: results from a case-control study. Infection 2022; 50:1383. [PMID: 35900672 PMCID: PMC9330932 DOI: 10.1007/s15010-022-01892-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy.
| | - A Curtolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - L Volpicelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - F Cancelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - C Borrazzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - F Cogliati Dezza
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - G Marcelli
- Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - F Gavaruzzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - S Di Bari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - P Ricci
- Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - O Turriziani
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - C M Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
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Castelluccia A, Marchesano D, Grimaldi G, Annessi I, Bianciardi F, Di Palma A, Confaloni V, Rea F, Tolu B, Valentino M, Verna L, Rago M, Borrazzo C, Capone L, Masi M, El Gawhary R, Gentile P. PO-1401 MR-guided adaptive versus CT-guided SBRT for prostate cancer: where is cost-benefit balance? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03365-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Castelluccia A, Marchesano D, Grimaldi G, Annessi I, Bianciardi F, Borrazzo C, Di Palma A, El Gawhary R, Masi M, Rago M, Valentino M, Verna L, Gentile P. PD-0495 Stereotactic MR-guided Adaptive RT for rectal cancer: toxicity, radiological & pathological response. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02866-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Castelluccia A, Marchesano D, Grimaldi G, Annessi I, Bianciardi F, Di Palma A, Valentino M, Verna L, Confaloni V, Rea F, Tolu B, Borrazzo C, Rago M, Masi M, El Gawhary R, Gentile P. MR-guided adaptive versus CT-guided stereotactic radiotherapy for prostate cancer: Where is the best cost-benefit balance? Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01037-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Preziosi E, Bettiol M, Borrazzo C, Pacilio M, Bennati P, Borasi G. 230. A novel geometry for gamma-prompt imaging in proton therapy. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bettiol M, Preziosi E, Borrazzo C. 315. A double purpose phoswich approach for scintillation detectors in Nuclear Imaging. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Pacilio M, Ventroni G, Frantellizzi V, Cassano B, Montesano T, Borrazzo C, Basile C, Mango L, De Vincentis G, Pacilio M, Frantellizzi V, Verdolino E, Borrazzo C, Cassano B, Ventroni G, Mango L, De Vincentis G. 330. 223Ra therapy of bone metastases for castration-resistant prostate cancer (CRPC): Lesion dosimetry and follow-up for a large group of patients. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Pacilio M, Ventroni G, Frantellizzi V, Cassano B, Montesano T, Borrazzo C, Basile C, Mango L, De Vincentis G. 97. Towards a dose-response correlation in radioiodine therapy of hyperthyroidism from nodular thyroid disease. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Carnı̀ M, Borrazzo C, Galea N, Vullo F, Francone M, Catalano C, Carbone I, Pacilio M. 19. Comparison of myocardial blood flow estimates from dynamic contrast-enhanced used in Cardiac Magnetic Resonance Imaging. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Bettiol M, Preziosi E, Borrazzo C, Cinti M, Gonzalez A, Pani R. Depth-of-interaction discrimination to correct parallax error in high resolution PET. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Caccia B, Pozzi S, Borrazzo C, Carni M, Di Castro E, Valentini S. Development of a computational tool for HIFU ablation therapy to assure safety of the patient. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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