Impact of ceftazidime avibactam on colonization by carbapenem resistant Enterobacterales during treatment of related infections
Abstract Carbapenem-resistant Enterobacterales (CRE), particularly carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Escherichia coli (CREC), are significant pathogens causing healthcare-associated infections. This retrospective study assesses the effectiveness of ceftazidim...
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Nature Portfolio
2025-08-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-14817-z |
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| author | Uğur Önal Ülkü Tüzemen Pınar Küçükdemirci Kaya Deniz Mercan Funda Aslan Gül Çalışkan Remzi İşçimen Cüneyt Özakın Halis Akalın |
| author_facet | Uğur Önal Ülkü Tüzemen Pınar Küçükdemirci Kaya Deniz Mercan Funda Aslan Gül Çalışkan Remzi İşçimen Cüneyt Özakın Halis Akalın |
| author_sort | Uğur Önal |
| collection | DOAJ |
| description | Abstract Carbapenem-resistant Enterobacterales (CRE), particularly carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Escherichia coli (CREC), are significant pathogens causing healthcare-associated infections. This retrospective study assesses the effectiveness of ceftazidime-avibactam (CAZ/AVI) in achieving perianal swab (PAS) negativity compared to other treatments, including colistin, polymyxin B, meropenem, and combinations with fosfomycin. We retrospectively analyzed 147 CRE-colonized patients (76 females) screened with PAS samples from January 14, 2021, to April 27, 2024. Patients were divided into two groups: those treated with CAZ/AVI (n = 40) and those receiving alternative treatments (n = 44) for bloodstream infections or ventilator associated pneumonia caused by CRE. PAS negativity was defined as conversion from positive to negative, while relapse was a positive PAS result after initial negativity. A p-value below 0.05 was considered to be statistically significant. The CAZ/AVI group achieved a higher rate of PAS negativity (32 patients) with a median time to PAS negativity of 1 week. Relapse rates were similar between CAZ/AVI (23/24) and non-CAZ/AVI groups (8/10). Significant differences in PAS negativity were observed at two weeks (p < 0.001) but not at four weeks (p = 0.492). The median time to PAS negativity was shorter in the CAZ/AVI group (1 week) compared to the non-CAZ/AVI group (2 weeks; p = 0.027). CAZ/AVI is more effective than alternative treatments for short-term PAS negativity, but relapse rates are comparable, highlighting challenges in long-term CRE management. Continuous surveillance and personalized decolonization strategies are essential. Further research is needed to investigate relapse mechanisms and evaluate combination therapies or novel strategies for sustained decolonization. |
| format | Article |
| id | doaj-art-8bc7dc53a2674f058569054aedd7a369 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-8bc7dc53a2674f058569054aedd7a3692025-08-20T03:05:18ZengNature PortfolioScientific Reports2045-23222025-08-011511610.1038/s41598-025-14817-zImpact of ceftazidime avibactam on colonization by carbapenem resistant Enterobacterales during treatment of related infectionsUğur Önal0Ülkü Tüzemen1Pınar Küçükdemirci Kaya2Deniz Mercan3Funda Aslan4Gül Çalışkan5Remzi İşçimen6Cüneyt Özakın7Halis Akalın8Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bursa Uludağ UniversityFaculty of Medicine, Department of Medical Microbiology, Bursa Uludağ UniversityFaculty of Medicine, Department of Anesthesiology and Reanimation, Bursa Uludağ UniversityFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bursa Uludağ UniversityFaculty of Medicine, Bursa Uludağ University, Infection Control Committee, Infection Control NurseFaculty of Medicine, Bursa Uludağ University, Infection Control Committee, Infection Control NurseFaculty of Medicine, Department of Anesthesiology and Reanimation, Bursa Uludağ UniversityFaculty of Medicine, Department of Medical Microbiology, Bursa Uludağ UniversityFaculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bursa Uludağ UniversityAbstract Carbapenem-resistant Enterobacterales (CRE), particularly carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Escherichia coli (CREC), are significant pathogens causing healthcare-associated infections. This retrospective study assesses the effectiveness of ceftazidime-avibactam (CAZ/AVI) in achieving perianal swab (PAS) negativity compared to other treatments, including colistin, polymyxin B, meropenem, and combinations with fosfomycin. We retrospectively analyzed 147 CRE-colonized patients (76 females) screened with PAS samples from January 14, 2021, to April 27, 2024. Patients were divided into two groups: those treated with CAZ/AVI (n = 40) and those receiving alternative treatments (n = 44) for bloodstream infections or ventilator associated pneumonia caused by CRE. PAS negativity was defined as conversion from positive to negative, while relapse was a positive PAS result after initial negativity. A p-value below 0.05 was considered to be statistically significant. The CAZ/AVI group achieved a higher rate of PAS negativity (32 patients) with a median time to PAS negativity of 1 week. Relapse rates were similar between CAZ/AVI (23/24) and non-CAZ/AVI groups (8/10). Significant differences in PAS negativity were observed at two weeks (p < 0.001) but not at four weeks (p = 0.492). The median time to PAS negativity was shorter in the CAZ/AVI group (1 week) compared to the non-CAZ/AVI group (2 weeks; p = 0.027). CAZ/AVI is more effective than alternative treatments for short-term PAS negativity, but relapse rates are comparable, highlighting challenges in long-term CRE management. Continuous surveillance and personalized decolonization strategies are essential. Further research is needed to investigate relapse mechanisms and evaluate combination therapies or novel strategies for sustained decolonization.https://doi.org/10.1038/s41598-025-14817-zCarbapenem-resistant EnterobacteralesCeftazidime-avibactamPerianal swab negativityDecolonizationIntensive care unit |
| spellingShingle | Uğur Önal Ülkü Tüzemen Pınar Küçükdemirci Kaya Deniz Mercan Funda Aslan Gül Çalışkan Remzi İşçimen Cüneyt Özakın Halis Akalın Impact of ceftazidime avibactam on colonization by carbapenem resistant Enterobacterales during treatment of related infections Scientific Reports Carbapenem-resistant Enterobacterales Ceftazidime-avibactam Perianal swab negativity Decolonization Intensive care unit |
| title | Impact of ceftazidime avibactam on colonization by carbapenem resistant Enterobacterales during treatment of related infections |
| title_full | Impact of ceftazidime avibactam on colonization by carbapenem resistant Enterobacterales during treatment of related infections |
| title_fullStr | Impact of ceftazidime avibactam on colonization by carbapenem resistant Enterobacterales during treatment of related infections |
| title_full_unstemmed | Impact of ceftazidime avibactam on colonization by carbapenem resistant Enterobacterales during treatment of related infections |
| title_short | Impact of ceftazidime avibactam on colonization by carbapenem resistant Enterobacterales during treatment of related infections |
| title_sort | impact of ceftazidime avibactam on colonization by carbapenem resistant enterobacterales during treatment of related infections |
| topic | Carbapenem-resistant Enterobacterales Ceftazidime-avibactam Perianal swab negativity Decolonization Intensive care unit |
| url | https://doi.org/10.1038/s41598-025-14817-z |
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