Seven-day antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients: toward a new paradigm
Purpose Data on short courses of antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients are limited. The aim of the study was to describe and compare the frequency of bacteremia relapse, 30-day overall and infection-related mortality, Clostridiodes difficile infection a...
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| Veröffentlicht in: | European journal of clinical microbiology & infectious diseases 2024-09, Vol.43 (9), p.1741-1751 |
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| container_title | European journal of clinical microbiology & infectious diseases |
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| creator | Herrera, Fabián Torres, Diego Laborde, Ana Jordán, Rosana Tula, Lucas Mañez, Noelia Pereyra, María Laura Suchowiercha, Nadia Berruezo, Lorena Gudiol, Carlota Ibáñez, María Luz González Eusebio, María José Lambert, Sandra Barcán, Laura Rossi, Inés Roccia Nicola, Federico Pennini, Magdalena Monge, Renata Blanco, Miriam Visús, Mariángeles Reynaldi, Mariana Carbone, Ruth Pasterán, Fernando Corso, Alejandra Rapoport, Melina Carena, Alberto Angel |
| description | Purpose
Data on short courses of antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients are limited. The aim of the study was to describe and compare the frequency of bacteremia relapse, 30-day overall and infection-related mortality,
Clostridiodes difficile
infection and length of hospital stay since bacteremia among those who received antibiotic therapy for 7 or 14 days.
Methods
This is a multicenter, prospective, observational cohort study in adult high-risk neutropenic patients with hematologic malignancies or hematopoietic stem cell transplant and monomicrobial Enterobacterales bacteremia. They received appropriate empirical antibiotic therapy, had a clinical response within 7 days, and infection source control. Clinical, epidemiological and outcomes variables were compared based on 7 or 14 days of AT.
Results
Two hundred patients were included (100, 7-day antibiotic therapy; 100, 14-day antibiotic therapy).
Escherichia coli
was the pathogen most frequently isolated (47.5%), followed by
Klebsiella
sp
.
(40.5%). Among those patients that received 7-day vs. 14-day antibiotic course, a clinical source of bacteremia was found in 54% vs. 57% (
p
= 0.66), multidrug-resistant Enterobacterales isolates in 28% vs. 30% (
p
= 0.75), and 40% vs. 47% (
p
= 0.31) received combined empirical antibiotic therapy. Overall mortality was 3% vs. 1% (
p
= 0.62), in no case related to infection; bacteremia relapse was 7% vs. 2% (
p
= 0.17), and length of hospital stay since bacteremia had a median of 9 days (IQR: 7–15) vs. 14 days (IQR: 13–22) (
p
= |
| doi_str_mv | 10.1007/s10096-024-04885-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3075377855</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3097591552</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-80cb8cd0ef92df79cdf79b4db96f52cd658b9dab1a350a409c32d3f9b4bc13323</originalsourceid><addsrcrecordid>eNp9kU2PFCEQhonRuOPqH_BgSLx4QemmGcCb2awfySYe1DPho3qGdRpaoHcy_17GXjXx4KWqQj3vSyUvQs87-rqjVLwpraotof1A6CAlJ8cHaNMNjJOBCfYQbahiA1GiZxfoSSm3tImkEI_RBZOKS0nVBi1f4A4i8eaETazBhlSDw3UP2cwnPKaMr2OFnKxxrZkDFLyOMAWDQ8T7sNuTHMp3HGGpOc0Qm8FsaoBYy1tc09Fkj01bH9tzNj7spqfo0WgOBZ7d90v07f3116uP5Obzh09X726I6_m2Ekmdlc5TGFXvR6HcudjBW7Udee_8lkurvLGdYZyagSrHes_GhljXMdazS_Rq9Z1z-rFAqXoKxcHhYCKkpWhGBWdCSM4b-vIf9DYtObbrGqUEVx3nZ8N-pVxOpWQY9ZzDZPJJd1SfQ9FrKLqFon-Foo9N9OLeerET-D-S3yk0gK1Aaau4g_z37__Y_gS3wJqO</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3097591552</pqid></control><display><type>article</type><title>Seven-day antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients: toward a new paradigm</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Herrera, Fabián ; Torres, Diego ; Laborde, Ana ; Jordán, Rosana ; Tula, Lucas ; Mañez, Noelia ; Pereyra, María Laura ; Suchowiercha, Nadia ; Berruezo, Lorena ; Gudiol, Carlota ; Ibáñez, María Luz González ; Eusebio, María José ; Lambert, Sandra ; Barcán, Laura ; Rossi, Inés Roccia ; Nicola, Federico ; Pennini, Magdalena ; Monge, Renata ; Blanco, Miriam ; Visús, Mariángeles ; Reynaldi, Mariana ; Carbone, Ruth ; Pasterán, Fernando ; Corso, Alejandra ; Rapoport, Melina ; Carena, Alberto Angel</creator><creatorcontrib>Herrera, Fabián ; Torres, Diego ; Laborde, Ana ; Jordán, Rosana ; Tula, Lucas ; Mañez, Noelia ; Pereyra, María Laura ; Suchowiercha, Nadia ; Berruezo, Lorena ; Gudiol, Carlota ; Ibáñez, María Luz González ; Eusebio, María José ; Lambert, Sandra ; Barcán, Laura ; Rossi, Inés Roccia ; Nicola, Federico ; Pennini, Magdalena ; Monge, Renata ; Blanco, Miriam ; Visús, Mariángeles ; Reynaldi, Mariana ; Carbone, Ruth ; Pasterán, Fernando ; Corso, Alejandra ; Rapoport, Melina ; Carena, Alberto Angel ; Argentine Group for the Study of Bacteremia in Cancer, Stem Cell Transplant (ROCAS) Study ; for The Argentine Group for the Study of Bacteremia in Cancer, Stem Cell Transplant (ROCAS) Study</creatorcontrib><description>Purpose
Data on short courses of antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients are limited. The aim of the study was to describe and compare the frequency of bacteremia relapse, 30-day overall and infection-related mortality,
Clostridiodes difficile
infection and length of hospital stay since bacteremia among those who received antibiotic therapy for 7 or 14 days.
Methods
This is a multicenter, prospective, observational cohort study in adult high-risk neutropenic patients with hematologic malignancies or hematopoietic stem cell transplant and monomicrobial Enterobacterales bacteremia. They received appropriate empirical antibiotic therapy, had a clinical response within 7 days, and infection source control. Clinical, epidemiological and outcomes variables were compared based on 7 or 14 days of AT.
Results
Two hundred patients were included (100, 7-day antibiotic therapy; 100, 14-day antibiotic therapy).
Escherichia coli
was the pathogen most frequently isolated (47.5%), followed by
Klebsiella
sp
.
(40.5%). Among those patients that received 7-day vs. 14-day antibiotic course, a clinical source of bacteremia was found in 54% vs. 57% (
p
= 0.66), multidrug-resistant Enterobacterales isolates in 28% vs. 30% (
p
= 0.75), and 40% vs. 47% (
p
= 0.31) received combined empirical antibiotic therapy. Overall mortality was 3% vs. 1% (
p
= 0.62), in no case related to infection; bacteremia relapse was 7% vs. 2% (
p
= 0.17), and length of hospital stay since bacteremia had a median of 9 days (IQR: 7–15) vs. 14 days (IQR: 13–22) (
p
= < 0.001).
Conclusions
These data suggest that seven-day antibiotic therapy might be adequate for patients with high-risk neutropenia and Enterobacterales bacteremia, who receive appropriate empirical therapy, with clinical response and infection source control.</description><identifier>ISSN: 0934-9723</identifier><identifier>ISSN: 1435-4373</identifier><identifier>EISSN: 1435-4373</identifier><identifier>DOI: 10.1007/s10096-024-04885-w</identifier><identifier>PMID: 38958809</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Anti-Bacterial Agents - administration & dosage ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Bacteremia ; Bacteremia - drug therapy ; Bacteremia - microbiology ; Bacteremia - mortality ; Biomedical and Life Sciences ; Biomedicine ; E coli ; Enterobacterales ; Enterobacteriaceae - drug effects ; Enterobacteriaceae Infections - drug therapy ; Enterobacteriaceae Infections - microbiology ; Enterobacteriaceae Infections - mortality ; Epidemiology ; Female ; Hematologic Neoplasms - complications ; Hematopoietic stem cells ; Hospitals ; Humans ; Infections ; Internal Medicine ; Klebsiella ; Length of Stay ; Male ; Malignancy ; Medical Microbiology ; Middle Aged ; Mortality ; Multidrug resistance ; Neutropenia ; Neutropenia - complications ; Observational studies ; Patients ; Prospective Studies ; Stem cell transplantation ; Stem cells ; Therapy ; Treatment Outcome ; Young Adult</subject><ispartof>European journal of clinical microbiology & infectious diseases, 2024-09, Vol.43 (9), p.1741-1751</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-80cb8cd0ef92df79cdf79b4db96f52cd658b9dab1a350a409c32d3f9b4bc13323</cites><orcidid>0000-0001-8900-4400</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10096-024-04885-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10096-024-04885-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38958809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Herrera, Fabián</creatorcontrib><creatorcontrib>Torres, Diego</creatorcontrib><creatorcontrib>Laborde, Ana</creatorcontrib><creatorcontrib>Jordán, Rosana</creatorcontrib><creatorcontrib>Tula, Lucas</creatorcontrib><creatorcontrib>Mañez, Noelia</creatorcontrib><creatorcontrib>Pereyra, María Laura</creatorcontrib><creatorcontrib>Suchowiercha, Nadia</creatorcontrib><creatorcontrib>Berruezo, Lorena</creatorcontrib><creatorcontrib>Gudiol, Carlota</creatorcontrib><creatorcontrib>Ibáñez, María Luz González</creatorcontrib><creatorcontrib>Eusebio, María José</creatorcontrib><creatorcontrib>Lambert, Sandra</creatorcontrib><creatorcontrib>Barcán, Laura</creatorcontrib><creatorcontrib>Rossi, Inés Roccia</creatorcontrib><creatorcontrib>Nicola, Federico</creatorcontrib><creatorcontrib>Pennini, Magdalena</creatorcontrib><creatorcontrib>Monge, Renata</creatorcontrib><creatorcontrib>Blanco, Miriam</creatorcontrib><creatorcontrib>Visús, Mariángeles</creatorcontrib><creatorcontrib>Reynaldi, Mariana</creatorcontrib><creatorcontrib>Carbone, Ruth</creatorcontrib><creatorcontrib>Pasterán, Fernando</creatorcontrib><creatorcontrib>Corso, Alejandra</creatorcontrib><creatorcontrib>Rapoport, Melina</creatorcontrib><creatorcontrib>Carena, Alberto Angel</creatorcontrib><creatorcontrib>Argentine Group for the Study of Bacteremia in Cancer, Stem Cell Transplant (ROCAS) Study</creatorcontrib><creatorcontrib>for The Argentine Group for the Study of Bacteremia in Cancer, Stem Cell Transplant (ROCAS) Study</creatorcontrib><title>Seven-day antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients: toward a new paradigm</title><title>European journal of clinical microbiology & infectious diseases</title><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><description>Purpose
Data on short courses of antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients are limited. The aim of the study was to describe and compare the frequency of bacteremia relapse, 30-day overall and infection-related mortality,
Clostridiodes difficile
infection and length of hospital stay since bacteremia among those who received antibiotic therapy for 7 or 14 days.
Methods
This is a multicenter, prospective, observational cohort study in adult high-risk neutropenic patients with hematologic malignancies or hematopoietic stem cell transplant and monomicrobial Enterobacterales bacteremia. They received appropriate empirical antibiotic therapy, had a clinical response within 7 days, and infection source control. Clinical, epidemiological and outcomes variables were compared based on 7 or 14 days of AT.
Results
Two hundred patients were included (100, 7-day antibiotic therapy; 100, 14-day antibiotic therapy).
Escherichia coli
was the pathogen most frequently isolated (47.5%), followed by
Klebsiella
sp
.
(40.5%). Among those patients that received 7-day vs. 14-day antibiotic course, a clinical source of bacteremia was found in 54% vs. 57% (
p
= 0.66), multidrug-resistant Enterobacterales isolates in 28% vs. 30% (
p
= 0.75), and 40% vs. 47% (
p
= 0.31) received combined empirical antibiotic therapy. Overall mortality was 3% vs. 1% (
p
= 0.62), in no case related to infection; bacteremia relapse was 7% vs. 2% (
p
= 0.17), and length of hospital stay since bacteremia had a median of 9 days (IQR: 7–15) vs. 14 days (IQR: 13–22) (
p
= < 0.001).
Conclusions
These data suggest that seven-day antibiotic therapy might be adequate for patients with high-risk neutropenia and Enterobacterales bacteremia, who receive appropriate empirical therapy, with clinical response and infection source control.</description><subject>Adult</subject><subject>Aged</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Bacteremia</subject><subject>Bacteremia - drug therapy</subject><subject>Bacteremia - microbiology</subject><subject>Bacteremia - mortality</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>E coli</subject><subject>Enterobacterales</subject><subject>Enterobacteriaceae - drug effects</subject><subject>Enterobacteriaceae Infections - drug therapy</subject><subject>Enterobacteriaceae Infections - microbiology</subject><subject>Enterobacteriaceae Infections - mortality</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Hematologic Neoplasms - complications</subject><subject>Hematopoietic stem cells</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infections</subject><subject>Internal Medicine</subject><subject>Klebsiella</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Malignancy</subject><subject>Medical Microbiology</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multidrug resistance</subject><subject>Neutropenia</subject><subject>Neutropenia - complications</subject><subject>Observational studies</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Therapy</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0934-9723</issn><issn>1435-4373</issn><issn>1435-4373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2PFCEQhonRuOPqH_BgSLx4QemmGcCb2awfySYe1DPho3qGdRpaoHcy_17GXjXx4KWqQj3vSyUvQs87-rqjVLwpraotof1A6CAlJ8cHaNMNjJOBCfYQbahiA1GiZxfoSSm3tImkEI_RBZOKS0nVBi1f4A4i8eaETazBhlSDw3UP2cwnPKaMr2OFnKxxrZkDFLyOMAWDQ8T7sNuTHMp3HGGpOc0Qm8FsaoBYy1tc09Fkj01bH9tzNj7spqfo0WgOBZ7d90v07f3116uP5Obzh09X726I6_m2Ekmdlc5TGFXvR6HcudjBW7Udee_8lkurvLGdYZyagSrHes_GhljXMdazS_Rq9Z1z-rFAqXoKxcHhYCKkpWhGBWdCSM4b-vIf9DYtObbrGqUEVx3nZ8N-pVxOpWQY9ZzDZPJJd1SfQ9FrKLqFon-Foo9N9OLeerET-D-S3yk0gK1Aaau4g_z37__Y_gS3wJqO</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Herrera, Fabián</creator><creator>Torres, Diego</creator><creator>Laborde, Ana</creator><creator>Jordán, Rosana</creator><creator>Tula, Lucas</creator><creator>Mañez, Noelia</creator><creator>Pereyra, María Laura</creator><creator>Suchowiercha, Nadia</creator><creator>Berruezo, Lorena</creator><creator>Gudiol, Carlota</creator><creator>Ibáñez, María Luz González</creator><creator>Eusebio, María José</creator><creator>Lambert, Sandra</creator><creator>Barcán, Laura</creator><creator>Rossi, Inés Roccia</creator><creator>Nicola, Federico</creator><creator>Pennini, Magdalena</creator><creator>Monge, Renata</creator><creator>Blanco, Miriam</creator><creator>Visús, Mariángeles</creator><creator>Reynaldi, Mariana</creator><creator>Carbone, Ruth</creator><creator>Pasterán, Fernando</creator><creator>Corso, Alejandra</creator><creator>Rapoport, Melina</creator><creator>Carena, Alberto Angel</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8900-4400</orcidid></search><sort><creationdate>20240901</creationdate><title>Seven-day antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients: toward a new paradigm</title><author>Herrera, Fabián ; Torres, Diego ; Laborde, Ana ; Jordán, Rosana ; Tula, Lucas ; Mañez, Noelia ; Pereyra, María Laura ; Suchowiercha, Nadia ; Berruezo, Lorena ; Gudiol, Carlota ; Ibáñez, María Luz González ; Eusebio, María José ; Lambert, Sandra ; Barcán, Laura ; Rossi, Inés Roccia ; Nicola, Federico ; Pennini, Magdalena ; Monge, Renata ; Blanco, Miriam ; Visús, Mariángeles ; Reynaldi, Mariana ; Carbone, Ruth ; Pasterán, Fernando ; Corso, Alejandra ; Rapoport, Melina ; Carena, Alberto Angel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-80cb8cd0ef92df79cdf79b4db96f52cd658b9dab1a350a409c32d3f9b4bc13323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Bacteremia</topic><topic>Bacteremia - drug therapy</topic><topic>Bacteremia - microbiology</topic><topic>Bacteremia - mortality</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>E coli</topic><topic>Enterobacterales</topic><topic>Enterobacteriaceae - drug effects</topic><topic>Enterobacteriaceae Infections - drug therapy</topic><topic>Enterobacteriaceae Infections - microbiology</topic><topic>Enterobacteriaceae Infections - mortality</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Hematologic Neoplasms - complications</topic><topic>Hematopoietic stem cells</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infections</topic><topic>Internal Medicine</topic><topic>Klebsiella</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Malignancy</topic><topic>Medical Microbiology</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multidrug resistance</topic><topic>Neutropenia</topic><topic>Neutropenia - complications</topic><topic>Observational studies</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Therapy</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Herrera, Fabián</creatorcontrib><creatorcontrib>Torres, Diego</creatorcontrib><creatorcontrib>Laborde, Ana</creatorcontrib><creatorcontrib>Jordán, Rosana</creatorcontrib><creatorcontrib>Tula, Lucas</creatorcontrib><creatorcontrib>Mañez, Noelia</creatorcontrib><creatorcontrib>Pereyra, María Laura</creatorcontrib><creatorcontrib>Suchowiercha, Nadia</creatorcontrib><creatorcontrib>Berruezo, Lorena</creatorcontrib><creatorcontrib>Gudiol, Carlota</creatorcontrib><creatorcontrib>Ibáñez, María Luz González</creatorcontrib><creatorcontrib>Eusebio, María José</creatorcontrib><creatorcontrib>Lambert, Sandra</creatorcontrib><creatorcontrib>Barcán, Laura</creatorcontrib><creatorcontrib>Rossi, Inés Roccia</creatorcontrib><creatorcontrib>Nicola, Federico</creatorcontrib><creatorcontrib>Pennini, Magdalena</creatorcontrib><creatorcontrib>Monge, Renata</creatorcontrib><creatorcontrib>Blanco, Miriam</creatorcontrib><creatorcontrib>Visús, Mariángeles</creatorcontrib><creatorcontrib>Reynaldi, Mariana</creatorcontrib><creatorcontrib>Carbone, Ruth</creatorcontrib><creatorcontrib>Pasterán, Fernando</creatorcontrib><creatorcontrib>Corso, Alejandra</creatorcontrib><creatorcontrib>Rapoport, Melina</creatorcontrib><creatorcontrib>Carena, Alberto Angel</creatorcontrib><creatorcontrib>Argentine Group for the Study of Bacteremia in Cancer, Stem Cell Transplant (ROCAS) Study</creatorcontrib><creatorcontrib>for The Argentine Group for the Study of Bacteremia in Cancer, Stem Cell Transplant (ROCAS) Study</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical microbiology & infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Herrera, Fabián</au><au>Torres, Diego</au><au>Laborde, Ana</au><au>Jordán, Rosana</au><au>Tula, Lucas</au><au>Mañez, Noelia</au><au>Pereyra, María Laura</au><au>Suchowiercha, Nadia</au><au>Berruezo, Lorena</au><au>Gudiol, Carlota</au><au>Ibáñez, María Luz González</au><au>Eusebio, María José</au><au>Lambert, Sandra</au><au>Barcán, Laura</au><au>Rossi, Inés Roccia</au><au>Nicola, Federico</au><au>Pennini, Magdalena</au><au>Monge, Renata</au><au>Blanco, Miriam</au><au>Visús, Mariángeles</au><au>Reynaldi, Mariana</au><au>Carbone, Ruth</au><au>Pasterán, Fernando</au><au>Corso, Alejandra</au><au>Rapoport, Melina</au><au>Carena, Alberto Angel</au><aucorp>Argentine Group for the Study of Bacteremia in Cancer, Stem Cell Transplant (ROCAS) Study</aucorp><aucorp>for The Argentine Group for the Study of Bacteremia in Cancer, Stem Cell Transplant (ROCAS) Study</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Seven-day antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients: toward a new paradigm</atitle><jtitle>European journal of clinical microbiology & infectious diseases</jtitle><stitle>Eur J Clin Microbiol Infect Dis</stitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>43</volume><issue>9</issue><spage>1741</spage><epage>1751</epage><pages>1741-1751</pages><issn>0934-9723</issn><issn>1435-4373</issn><eissn>1435-4373</eissn><abstract>Purpose
Data on short courses of antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients are limited. The aim of the study was to describe and compare the frequency of bacteremia relapse, 30-day overall and infection-related mortality,
Clostridiodes difficile
infection and length of hospital stay since bacteremia among those who received antibiotic therapy for 7 or 14 days.
Methods
This is a multicenter, prospective, observational cohort study in adult high-risk neutropenic patients with hematologic malignancies or hematopoietic stem cell transplant and monomicrobial Enterobacterales bacteremia. They received appropriate empirical antibiotic therapy, had a clinical response within 7 days, and infection source control. Clinical, epidemiological and outcomes variables were compared based on 7 or 14 days of AT.
Results
Two hundred patients were included (100, 7-day antibiotic therapy; 100, 14-day antibiotic therapy).
Escherichia coli
was the pathogen most frequently isolated (47.5%), followed by
Klebsiella
sp
.
(40.5%). Among those patients that received 7-day vs. 14-day antibiotic course, a clinical source of bacteremia was found in 54% vs. 57% (
p
= 0.66), multidrug-resistant Enterobacterales isolates in 28% vs. 30% (
p
= 0.75), and 40% vs. 47% (
p
= 0.31) received combined empirical antibiotic therapy. Overall mortality was 3% vs. 1% (
p
= 0.62), in no case related to infection; bacteremia relapse was 7% vs. 2% (
p
= 0.17), and length of hospital stay since bacteremia had a median of 9 days (IQR: 7–15) vs. 14 days (IQR: 13–22) (
p
= < 0.001).
Conclusions
These data suggest that seven-day antibiotic therapy might be adequate for patients with high-risk neutropenia and Enterobacterales bacteremia, who receive appropriate empirical therapy, with clinical response and infection source control.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38958809</pmid><doi>10.1007/s10096-024-04885-w</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-8900-4400</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0934-9723 |
| ispartof | European journal of clinical microbiology & infectious diseases, 2024-09, Vol.43 (9), p.1741-1751 |
| issn | 0934-9723 1435-4373 1435-4373 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3075377855 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - therapeutic use Antibiotics Bacteremia Bacteremia - drug therapy Bacteremia - microbiology Bacteremia - mortality Biomedical and Life Sciences Biomedicine E coli Enterobacterales Enterobacteriaceae - drug effects Enterobacteriaceae Infections - drug therapy Enterobacteriaceae Infections - microbiology Enterobacteriaceae Infections - mortality Epidemiology Female Hematologic Neoplasms - complications Hematopoietic stem cells Hospitals Humans Infections Internal Medicine Klebsiella Length of Stay Male Malignancy Medical Microbiology Middle Aged Mortality Multidrug resistance Neutropenia Neutropenia - complications Observational studies Patients Prospective Studies Stem cell transplantation Stem cells Therapy Treatment Outcome Young Adult |
| title | Seven-day antibiotic therapy for Enterobacterales bacteremia in high-risk neutropenic patients: toward a new paradigm |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T05%3A51%3A19IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Seven-day%20antibiotic%20therapy%20for%20Enterobacterales%20bacteremia%20in%20high-risk%20neutropenic%20patients:%20toward%20a%20new%20paradigm&rft.jtitle=European%20journal%20of%20clinical%20microbiology%20&%20infectious%20diseases&rft.au=Herrera,%20Fabi%C3%A1n&rft.aucorp=Argentine%20Group%20for%20the%20Study%20of%20Bacteremia%20in%20Cancer,%20Stem%20Cell%20Transplant%20(ROCAS)%20Study&rft.date=2024-09-01&rft.volume=43&rft.issue=9&rft.spage=1741&rft.epage=1751&rft.pages=1741-1751&rft.issn=0934-9723&rft.eissn=1435-4373&rft_id=info:doi/10.1007/s10096-024-04885-w&rft_dat=%3Cproquest_cross%3E3097591552%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3097591552&rft_id=info:pmid/38958809&rfr_iscdi=true |