TY - JOUR
T1 - Insights into the clinical management of carbapenem-resistant Gram-negative infections
T2 - An Italian retrospective clinical chart review
AU - Granata, Guido
AU - Manissero, Davide
AU - Oppia, Maria Vittoria
AU - Tone, Keiko
AU - Cai, Bin
AU - Longshaw, Christopher
AU - Venditti, Carolina
AU - Petrosillo, Nicola
PY - 2020
Y1 - 2020
N2 - There is a lack of consensus regarding management of infections with carbapenem-resistant Gram-negative (CR-GN) pathogens. This study comprised a medical chart review to assess patient management in a high CR prevalence setting. Data was collated retrospectively from medical records of patients hospitalized between November 1st, 2015 and October 31st, 2016. Of 29 patients, 66% had respiratory tract infections. Median duration of hospitalization was 28 days and ~50% of patients were admitted to the intensive care unit, with 77% remaining for >2 weeks. Median time to obtain respiratory culture results was 5 days. Isolation of patients with diagnosed CR-GN infection took ≥5 days in >50% of patients. A majority (76%) of patients received ≥1 antibiotic before providing a specimen for culture; a total of 17 antibiotic treatments were used. Overall, 72% of patients, and 68% of those with respiratory infections, were discharged alive; 38% were discharged without further antibiotics. The difficulties in achieving effective management in patients with CR-GN infections are largely due to complex co-morbidities, a Non history of prior antibiotic treatment, and multiple referrals across health care facilities.
AB - There is a lack of consensus regarding management of infections with carbapenem-resistant Gram-negative (CR-GN) pathogens. This study comprised a medical chart review to assess patient management in a high CR prevalence setting. Data was collated retrospectively from medical records of patients hospitalized between November 1st, 2015 and October 31st, 2016. Of 29 patients, 66% had respiratory tract infections. Median duration of hospitalization was 28 days and ~50% of patients were admitted to the intensive care unit, with 77% remaining for >2 weeks. Median time to obtain respiratory culture results was 5 days. Isolation of patients with diagnosed CR-GN infection took ≥5 days in >50% of patients. A majority (76%) of patients received ≥1 antibiotic before providing a specimen for culture; a total of 17 antibiotic treatments were used. Overall, 72% of patients, and 68% of those with respiratory infections, were discharged alive; 38% were discharged without further antibiotics. The difficulties in achieving effective management in patients with CR-GN infections are largely due to complex co-morbidities, a Non history of prior antibiotic treatment, and multiple referrals across health care facilities.
KW - Antibiotic resistance
KW - Carbapenem resistance
KW - Clinical management
KW - Gram-negative bacteria
KW - Multi-drug resistance
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U2 - 10.4081/idr.2020.8510
DO - 10.4081/idr.2020.8510
M3 - Review article
AN - SCOPUS:85090997419
VL - 12
SP - 28
EP - 31
JO - Infectious Disease Reports
JF - Infectious Disease Reports
SN - 2036-7430
IS - 2
ER -