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Failure of Ceftazidime/Avibactam Experimental Therapy in the Treatment of Klebsiella Pneumoniae St11 Co-Producing Ndm-1 and Oxa-48 Carbapenemases Infection Publisher Pubmed



Nikbin VS1 ; Gholizadeh Khiavi EHA1 ; Dehghanilatani M2 ; Hosseinzadeh M3, 7 ; Shirzadi M4 ; Pourajam S4 ; Nouri S5 ; Solgi H6, 7
Authors
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Authors Affiliations
  1. 1. Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
  2. 2. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  6. 6. Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  7. 7. Amin Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Source: European Journal of Clinical Microbiology and Infectious Diseases Published:2024


Abstract

Carbapenem-resistant organisms (CRO) represent a significant threat because of their widespread in hospital settings, difficult-to-treat, and association with high morbidity and mortality rates. Data on the efficacy of ceftazidime/avibactam (CAZ-AVI) among patients infected with CRO in Iran are lacking. Herein, we report a case of a 91-year-old man with infection caused by extensively drug-resistant ST11 co-harbouring blaNDM and blaOXA−48−like strain from seven isolates. During ICU hospitalization, 10 different antibiotics were prescribed to the patient, and CAZ-AVI was experimentally prescribed in combination with tobramycin and tigecycline to the patient for the first time in the teaching hospitals of Isfahan City. The patient died on the 56th day of hospitalization. The present study revealed that the use of CAZ-AVI should be limited to targeted therapy after susceptibility results and minimum inhibitory concentration values are available to the treating clinicians and not be used for empirical therapy of patients with an infection caused by CRO, underscoring the urgent need for stringent policies for antibiotic stewardship to preserve the activity of novel β-lactam/β-lactamase inhibitors. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
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