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https://hdl.handle.net/2440/130943
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Type: | Journal article |
Title: | Treatment of invasive IMP-4 Enterobacter cloacae infection in transplant recipients using ceftazidime/avibactam with aztreonam: A case series and literature review |
Author: | Cairns, K.A. Hall, V. Martin, G.E. Griffin, D.W.J. Stewart, J.D. Khan, S.F. Abbott, I.J. Meher-Homji, Z. Morrissey, C.O. Sia, C. Love, J. Corallo, C.E. Bergin, P. Sharma, A. Gopal, B. Spencer, A. Peleg, A.Y. |
Citation: | Transplant Infectious Disease, 2020; 23(2):1-10 |
Publisher: | Wiley |
Issue Date: | 2020 |
ISSN: | 1398-2273 1399-3062 |
Statement of Responsibility: | Kelly A. Cairns, Victoria Hall, Genevieve E. Martin, David W.J. Griffin, James D. Stewart, Sadid F. Khan ... et al. |
Abstract: | Infections caused by carbapenemase-producing Enterobacteriaceae (CPE) are an emerging threat in both solid organ and stem cell transplant recipients. Invasive CPE infections in transplant recipients are associated with a high mortality, often due to limited therapeutic options and antibacterial toxicities. One of the most therapeutically challenging group of CPE are the metallo-β-lactamase (MBL)-producing Gram-negative bacteria, which are now found worldwide, and often need treatment with older, highly toxic antimicrobial regimens. Newer β-lactamase inhibitors such as avibactam have well-established activity against certain carbapenemases such as Klebsiella pneumoniae carbapenemases (KPC), but have no activity against MBL-producing organisms. Conversely, aztreonam has activity against MBL-producing organisms but is often inactivated by other co-existing β-lactamases. Here, we report four cases of invasive MBL-CPE infections in transplant recipients caused by IMP-4-producing Enterobacter cloacae who were successfully treated with a new, mechanism-driven antimicrobial combination of ceftazidime/avibactam with aztreonam. This novel antimicrobial combination offers a useful treatment option for high-risk patients with CPE infection, with reduced drug interactions and toxicity. |
Keywords: | E. cloacae MBL antimicrobial resistance antimicrobials metallo-beta-lactamase |
Rights: | © 2020 Wiley Periodicals LLC. |
DOI: | 10.1111/tid.13510 |
Published version: | http://dx.doi.org/10.1111/tid.13510 |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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