Clinical success of anti-infective combination therapy compare to monotherapy in patients with carbapenem-resistant Pseudomonas aeruginosa infection: a 10-years retrospective study

被引:2
作者
Chen, Jialong [1 ,2 ]
Lin, Jing [2 ,3 ]
Weng, Jianzhen [1 ]
Ju, Yang [1 ]
Li, Yanming [1 ]
机构
[1] Chinese Acad Med Sci, Beijing Hosp, Inst Geriatr Med, Natl Ctr Gerontol,Dept Pulm & Crit Care Med, Beijing, Peoples R China
[2] Chinese Acad Med Sci, Peking Union Med Coll, Grad Sch, Beijing, Peoples R China
[3] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Peking Union Med Coll, Dept Infect Dis, Beijing, Peoples R China
关键词
Monotherapy; Combination therapy; Carbapenem-resistant Pseudomonas aeruginosa; Effectiveness; IN-VITRO; ACINETOBACTER-BAUMANNII; ANTIMICROBIAL THERAPY; RISK-FACTORS; POLYMYXIN-B; COLISTIN; BACTEREMIA; MEROPENEM; MORTALITY;
D O I
10.1186/s12879-024-09060-2
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection has become a major public health concern. The recommendations for monotherapy and combination therapy in the current guidelines lack sufficient evidence to support them. The primary objective of this study is to determine the effectiveness of anti-Infective combination therapy compared to monotherapy in achieving clinical success in patients with CRPA infection and risk factors of clinical failure of monotherapy. Methods: A retrospective study from Medical Information Mart for Intensive Care IV (MIMIC-IV) was conducted. We included adults with infections caused by CRPA. The outcomes of this study were clinical success, complete clinical success, and 28-day all-cause mortality. Results: A total of 279 subjects were finally enrolled. The rate of clinical success for combination therapy was higher than that for monotherapy (73.1% versus 60.4%, p=0.028). Compared to clinical failure patients, patients in the clinical success group were more likely to die within 28 days after CRPA was found (48.3% versus 3.6%, p<0.001). In a multivariate logistic regression analysis, monotherapy was found to be significantly correlated with clinical success (OR, 0.559, 95% CI, 0.321-0.976; p = 0.041). Conclusion: Combination therapy is more effective for CRPA infection patients, especially those whose SOFA score is >= 2 or whose Charlson comorbidity index is >= 6.
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页数:10
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