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oai:repisalud.isciii.es:20.500.12105/204932025-05-05T15:02:36Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16958col_20.500.12105_16963col_20.500.12105_16967col_20.500.12105_16970col_20.500.12105_16982
Repisalud author Harris, Patrick NA author Pezzani, M. Diletta author Gutierrez-Gutierrez, Belen author Viale, Pierluigi author Hsueh, Po-Ren author Ruiz-Garbajosa, Patricia author Venditti, Mario author Tumbarello, Mario author Navarro-Francisco, Carolina author Calbo, Esther author Akova, Murat author Giamarellou, Helen author Oliver, Antonio author Almirante, Benito author Gasch, Oriol author Martinez-Martinez, Luis author Schwaber, Mitchell J author Daikos, George author Pitout, Johann author Pena, Carmen author Hernandez-Torres, Alicia author Doi, Yohei author Perez, Federico author Tuon, Felipe Francisco author Tacconelli, Evelina author Carmeli, Yehuda author Bonomo, Robert A author Pascual, Álvaro author Paterson, David L author Rodriguez-Bano, Jesus author ESGBIS Grp author REIPI Grp author INCREMENT Grp 2024-07-11T09:12:20Z 2024-07-11T09:12:20Z 2017-11 Harris Patrick N. A., Pezzani M. Diletta, Gutierrez-Gutierrez Belen, Viale Pierluigi, Hsueh Po-Ren, Ruiz-Garbajosa Patricia, et al. Geographical variation in therapy for bloodstream infections due to multidrug-resistant Enterobacteriaceae: a post-hoc analysis of the INCREMENT study. Int J Antimicrob Agents. 2017 Nov;50(5):664-672. Epub 2017 Aug 3. 10.1016/j.ijantimicag.2017.08.005 1872-7913 0924-8579 International Journal of Antimicrobial Agents http://hdl.handle.net/20.500.13003/9593 28782704 L618762051 2-s2.0-85031115305 http://hdl.handle.net/20.500.12105/20493 414070900009 We describe regional differences in therapy for bloodstream infection (BSI) caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE). Patients (n = 1482) in 12 countries from an observational study of BSI caused by ESBL-E or CPE were included. Multivariate logistic regression was used to calculate adjusted odds ratios (aORs) for the influence of country of recruitment on empirical use of beta-lactam/beta-lactamase inhibitors (BLBLIs) or carbapenems, targeted use of BLBLIs for ESBL-E and use of targeted combination therapy for CPE. Compared with Spain, BLBLI use for empirical therapy was least likely in sites from Israel (aOR 0.34, 95% CI 0.14-0.81), Greece (aOR 0.49, 95% CI 0.26-0.94) and Canada (aOR 0.31, 95% CI 0.11-0.88) but more likely in Italy (aOR 1.58, 95% CI 1.11-2.25) and Turkey (aOR 2.09, 95% CI 1.14-3.81). Empirical carbapenem use was more likely in sites from Taiwan (aOR 1.73, 95% CI 1.03-2.92) and USA (aOR 1.89, 95% CI 1.053.39) and less likely in Italy (aOR 0.44, 95% CI 0.28-0.69) and Canada (aOR 0.10, 95% CI 0.01-0.74). Targeted BLBLIs for ESBL-E was more likely in Italian sites. Treatment at sites within Israel, Taiwan, Turkey and Brazil was associated with less combination therapy for CPE. Although this study does not provide precise data on the relative prevalence of ESBL-E or CPE, significant variation in therapy exists across countries even after adjustment for patient factors. Better understanding of what influences therapeutic choices for these infections will aid antimicrobial stewardship efforts. eng Extended-spectrum beta-lactamase Carbapenemase Carbapenems beta-Lactam/beta-lactamase inhibitor Escherichia coli Klebsiella pneumoniae Geographical variation in therapy for bloodstream infections due to multidrug-resistant Enterobacteriaceae: a post-hoc analysis of the INCREMENT study research article