Susceptibility of carbapenem-resistant Klebsiella pneumoniae in urinary tract infections: clinical efficacy of fosfomycin
Abstract
INTRODUCTION: The increasing prevalence of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) limits effective treatment options. The aim of this study was to evaluate the susceptibility patterns of CR-Kp strains isolated from urine cultures to oral treatment options recommended by the Infectious Diseases Society of America guidelines, and ceftazidime-avibactam. Additionally, clinical data and outcomes of patients diagnosed with CR-Kp urinary tract infections (UTI) who were treated with fosfomycin sodium-including therapy regimens (FSITR) were analyzed.
METHODOLOGY: This retrospective cohort study included adult patients with urine culture-proven CR-Kp between March 2016 and October 2022. Demographic and clinical data, antibiotic susceptibility, treatment outcomes, and one-month mortality (OMM) were evaluated.
RESULTS: A total of 179 patients were included. The susceptibility to fosfomycin tromethamol, nitrofurantoin, and co-trimoxazole (TMP-SMX) were (33.7%; 55/163), (7.7%; 13/167), and (11.1%; 20/179), respectively. All strains were resistant to ciprofloxacin. The susceptibility data compared until 2020 (pre-COVID-19) and afterwards, revealed TMP-SMX susceptibility (4.9% vs 24.1%, p = 0.0001) increased significantly. Susceptibility data for ceftazidime-avibactam were available for 22 isolates and 59% of the isolates were sensitive. OMM of the 179 patients with CR-Kp in urine cultures was 37.4% (67/179). There were 9 FSITR cases. Among those, microbiological eradication was…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 179 participants or records.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.