Akademik Veri Yönetim Sistemi
FLORA INFEKSIYON HASTALIKLARI VE KLINIK MIKROBIYOLOJI DERGISI, cilt.27, sa.2, ss.296-304, 2022 (ESCI)
Introduction: Infections caused by carbapenemase producing Klebsiella pneumoniae (CR-Kp), is a serious health problem worldwide because of limited treatment options and high mortality rate. In this study, it was aimed to determine the effect of dual carbapenem therapy (DCT) on mortality and other clinical outcomes in patients with CR-Kp bacteremia.Materials and Methods: Between January 2018 and December 2019, 111 bacteremic patients with CR-Kp growth in their blood culture, followed in the intensive care units and other services, 28 treated with ICT and 83 with other antibiotics were included in the study. From hospital information management system, discharge notes and clinical follow-up notes, these demographic information and risk factors were recorded retrospectively. The factors affecting mortality and other clinical outcomes after CR-Kp infection treatments were evaluated in the patients examined.Results: As a result of statistical analysis, in univariate analysis; higher Charlson Comorbidity Index, high SOFA and Pitt bacteremia scores (p= 0.010, p < 0.001 ve p= 0.001, respectively); history of hypertension, chronic renal disease or cerebrovascular accident (p= 0.001, p= 0.023, p= 0.024, respectively); totally parenteral nutrition (TPN) use (p= 0.001) and meropenem MIC values > 32 mg/L (p= 0.007), were associated with 28-day mortality rates. In our study, 28 and 60 day mortality rates were lower in the DCT group compared to the other group, but no statistically significant difference was found between the groups (50%-57.1% vs. 59%-65.1%; p= 0.539 and p= 0.600). The 5th day clinical response of both treatment groups was lower in the other treatment group than in the DCT group, but the statistical difference was not significant. No drug-related side effects were reported in any of the patients using DCT. Conclusion: Our study builds upon the already available literature on utilization of DCT for CR-Kp. Additionally, use of a comparative arm allows us to quantify the effectiveness of this therapy. We believe that in the face of extremely limited therapeutic options for the treatment of CR-Kp bloodstream infections, this novel and seemingly effective therapeutic approach warrants consideration and further investigation.