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Treatment Outcomes of Multidrug-Resistant Gram-Negative Bacterial Infections Treated with Ceftazidime-Avibactam in Severely Burned Patients with Sepsis
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Abstract
Objective: To evaluate the antimicrobial susceptibility of multidrug-resistant Gram-negative bacteria to ceftazidime-avibactam and the clinical outcomes of ceftazidime-avibactam therapy in severely burned patients with sepsis.
Subjects and methods: Thirty-four clinical specimens obtained from severely burned patients yielding multidrug-resistant Gram-negative bacteria (P. aeruginosa and K. pneumoniae) underwent antimicrobial susceptibility testing using multidrug-resistance card. Forty-nine patients with sepsis treated in the Intensive Care Unit, suspected or confirmed to be infected with P. aeruginosa or K. pneumoniae, received ceftazidime-avibactam either empirically or according to antimicrobial susceptibility results.
Results: P. aeruginosa demonstrated the highest susceptibility to ceftazidime-avibactam (61.11%), which was higher than that to ceftolozane-tazobactam (27.78%) and imipenem-relebactam (27.78%). Among the novel β-lactam/β-lactamase inhibitor combinations (N-BL/BLIs), ceftazidime-avibactam showed the highest susceptibility rate against K. pneumoniae (56.25%). The minimum inhibitory concentrations of ceftazidime-avibactam and imipenem-relebactam against P. aeruginosa and K. pneumoniae were the lowest among the N-BL/BLIs tested.
Among the 49 patients with sepsis, 91.84% developed septic shock. The predominant pathogen was P. aeruginosa (69.23% of blood culture isolates and 90.91% of wound culture isolates). The median duration of ceftazidime-avibactam therapy in burn patients with sepsis was 9 days. The mortality rate was 61.22%.
Conclusion: P. aeruginosa and K. pneumoniae remained highly susceptible to ceftazidime-avibactam. The mortality rate among burn patients with sepsis treated with ceftazidime-avibactam was 61.22%.
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Keywords
Burns, sepsis, ceftazidime-avibactam
References
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