Ceftazidime-avibactam in urinary tract infections due to carbapenemase-producing Klebsiella in kidney transplantation

Caravaca-Fontán, Fernando; Jiménez-Álvaro, Sara; Marcén-Letosa, Roberto; Fernández-Rodríguez, Ana; Rodríguez-Navarro, Carlos Quereda

doi:10.1016/j.nefroe.2015.10.002

Cited by 3 publications

(2 citation statements)

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“…143,144 It should be highlighted that none of these novel BLBLI combinations retain significant activity in the presence of MBLs. 129 Experience with new BLBLIs among SOT recipients has been mainly restricted to case reports [145][146][147][148] and small series with no comparator group. 149,150 The SET/GESITRA-SEIMC/REIPI document did not make any mention of MER-VAB or IMI-REL and simply suggested-based on low-quality evidence (CIII)-that CAZ-AVI may be considered for the treatment of CRE infections if the strain shows in vitro susceptibility.…”

Section: New Blbli Combinationsmentioning

confidence: 99%

Extended‐spectrum β‐lactamase‐producing and carbapenem‐resistant Enterobacterales bloodstream infection after solid organ transplantation: Recent trends in epidemiology and therapeutic approaches

Pérez‐Nadales

2022

Transplant Infectious Dis

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Background: Infections caused by multidrug-resistant gram-negative bacilli (MDR GNB), in particular extended-spectrum β-lactamase-producing (ESBL-E) and carbapenem-resistant Enterobacterales (CRE), pose a major threat in solid organ transplantation (SOT). Outcome prediction and therapy are challenging due to the scarcity of randomized clinical trials (RCTs) or well-designed observational studies focused on this population. Methods: Narrative review with a focus on the contributions provided by the ongoing multinational INCREMENT-SOT consortium (ClinicalTrials identifier NCT02852902) in the fields of epidemiology and clinical management. Results: The Spanish Society of Transplantation (SET), the Group for Study of Infection in Transplantation of the Spanish Society of Infectious Diseases and Clinical Microbiology (GESITRA-SEIMC), and the Spanish Network for Research in Infectious Diseases (REIPI) recently published their recommendations for the management of MDR GNB Elena Pérez-Nadales and Mario Fernández-Ruiz contributed equally to this work.

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Section: New Blbli Combinationsmentioning

confidence: 99%

Extended‐spectrum β‐lactamase‐producing and carbapenem‐resistant Enterobacterales bloodstream infection after solid organ transplantation: Recent trends in epidemiology and therapeutic approaches

Pérez‐Nadales

2022

Transplant Infectious Dis

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“…Carmargo et al described a 64-year-old female with KPC-producing K. pneumoniae successfully treated with ceftazidime-avibactam after multiple lines of therapy failed to resolve a peri-pancreatic collection after small bowel transplant [47]. Caravaca-Fontan et al detailed a patient with recurrent KPC-producing K. pneumoniae urinary tract infection after kidney transplant successfully cured of recurrence after treatment with ceftazidime-avibactam [48]. In terms of larger case series, Shields et al reported a single-center retrospective experience of 109 patients with carbapenem-resistant K. pneumoniae bacteremia (97% bla KPC ), with 40 (36.7%) being solid organ transplant recipients [49].…”

Section: Ceftazidime-avibactammentioning

confidence: 99%

Carbapenem-Resistant Enterobacteriaceae in Solid Organ Transplantation: Management Principles

Smibert

Satlin

Nellore

et al. 2019

Curr Infect Dis Rep

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Purpose of Review Carbapenem-resistant Enterobacteriaceae (CRE) have emerged as a worldwide problem. Given their degree of immunosuppression and the level of contact with the healthcare system, solid organ transplant (SOT) recipients are at a disproportionately higher risk of acquisition, colonization, and infection with CRE, and outcomes from infection tend to be worse compared to non-transplant patients. Therapeutic options are limited for CRE infections although several newer agents have recently been approved for use. How well these agents perform in the setting of immunosuppression and SOT is unclear. We sought to review the epidemiology of CRE in SOT and the management principles. Recent Findings CRE infections are becoming an increasing problem in SOT, and donor-derived infections present a challenge in the peri-transplant period. Newer treatments for CRE are emerging that are less toxic and potentially more effective than prior CRE-active agents, but supportive clinical data are limited. Newer beta-lactamase inhibitors have good activity against KPC carbapenemases, but they lack activity against metallo-beta-lactamases (e.g., NDM). Promising data is emerging with newer agents that have activity against most carbapenemases, but, again, clinical data is needed. Combination therapy in addition to optimal pharmacokinetic and pharmacodynamics may go some way to improve outcomes against these difficult-to-treat organisms. Other novel therapies that prevent the emergence of resistance (oral beta-lactamase inhibitors) and eradication of resistant Gram-negative colonization (fecal microbiota transplant) may eventually become part of a bundle approach to reduce CRE infections in the future. Summary As in non-transplant patients, CRE infections in the transplant setting are challenging to treat and prevent. Infection prevention and control remains crucial to prevent widespread dissemination, and unique challenges exist with donor-derived CRE and how best to manage recipients in the peri-transplant period. Newer treatments are now in early-phase clinical studies, and in vitro activity data are supportive for several agents providing hope for improved outcomes with these typically difficult-totreat and highly morbid infections in transplant recipients.

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Meropenem

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Ceftazidime-avibactam in urinary tract infections due to carbapenemase-producing Klebsiella in kidney transplantation

Cited by 3 publications

References 4 publications

Extended‐spectrum β‐lactamase‐producing and carbapenem‐resistant Enterobacterales bloodstream infection after solid organ transplantation: Recent trends in epidemiology and therapeutic approaches

Extended‐spectrum β‐lactamase‐producing and carbapenem‐resistant Enterobacterales bloodstream infection after solid organ transplantation: Recent trends in epidemiology and therapeutic approaches

Carbapenem-Resistant Enterobacteriaceae in Solid Organ Transplantation: Management Principles

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