678. Title: Treatment Outcomes with Carbapenems vs. Non-Carbapenem Beta-Lactams in Infections with Carbapenem-Discordant <i>Enterobacter cloacae</i> Complex
نویسندگان
چکیده
Abstract Background Carbapenem-discordant Enterobacter cloacae complex (CDECC) isolates are defined as ertapenem non-susceptible and meropenem susceptible drug phenotype. The optimal treatment of these infections is unknown. In 2021, the Infectious Diseases Society America released guidance recommending extended infusion preferred option. Newer agents, including ceftazidime-avibactam, may be effective but comparative data lacking. Evaluation outcomes for use in with CDECC necessary to establish therapy. Methods This single center, retrospective, cohort study was conducted at University Kansas Hospital from January 2016 June 2021. Individuals least 18 years age non-urinary culture positive that were treated either (MEM) or a non-carbapenem beta-lactam (NCBL) included. polymicrobial infections, urinary source, death within 72 hours admission excluded. primary outcome clinical failure, which composite endpoint. Secondary included individual components outcome. Results There 29 unique episodes monomicrobial, carbapenem-discordant during period. met 6 patients receiving NCBL MEM, respectively (67% vs. 30%, p=0.11). A total 8 died 30 days, 4 MEM group (20% 44%, p = 0.21). Univariate logistic regression analysis demonstrated significant increase need modify antibiotic therapy (OR 15.2, 95% CI, 1.37-168; p=0.02), trend towards increased risk in-hospital 30-day mortality (OR, 3.2; 0.58-17.72; 0.18). Conclusion no difference failure rates between groups. However, NCBLs associated modifications due decompensation. Larger studies needed assess define Disclosures All Authors: No reported disclosures.
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ژورنال
عنوان ژورنال: Open Forum Infectious Diseases
سال: 2022
ISSN: ['2328-8957']
DOI: https://doi.org/10.1093/ofid/ofac492.730