Hadas Ofer-Friedman1, Coral Shefler2, Sarit Sharma3, Amit Tirosh4, Ruthy Tal-Jasper2, Deepthi Kandipalli3, Shruti Sharma3, Pradeep Bathina3, Tamir Kaplansky1, Moran Maskit1, Tal Azouri1, Tsilia Lazarovitch5, Ronit Zaidenstein4, Keith S. Kaye3, Dror Marchaim2,1
1Unit of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, Israel
2Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
3Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan, USA
4Department of Medicine “A,”, Assaf Harofeh Medical Center, Zerifin, Israel
5Clinical Microbiology Laboratory, Assaf Harofeh Medical Center, Zerifin, Israel
Tóm tắt
A recent, frequently quoted study has suggested that for bloodstream infections (BSIs) due to extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL) Escherichia coli, treatment with β-lactam/β-lactamase inhibitors (BLBLIs) might be equivalent to treatment with carbapenems. However, the majority of BSIs originate from the urinary tract. A multicenter, multinational efficacy analysis was conducted from 2010 to 2012 to compare outcomes of patients with non-urinary ESBL BSIs who received a carbapenem (69 patients) vs those treated with piperacillin-tazobactam (10 patients). In multivariate analysis, therapy with piperacillin-tazobactam was associated with increased 90-day mortality (adjusted odds ratio, 7.9, P=.03). For ESBL BSIs of a non-urinary origin, carbapenems should be considered a superior treatment to BLBLIs.Infect Control Hosp Epidemiol 2015;36(8):981–985
