Efficacy of cefoperazone-sulbactam as a component of combination therapy for carbapenem-resistant Acinetobacter baumannii bloodstream infection in intensive care units: a multicenter retrospective propensity score-matched study
Abstract Background In this study, we aimed to evaluate the efficacy of cefoperazone-sulbactam-containing (CSC) combination therapy for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections (BSI) patients in intensive care unit (ICU). Methods This multicenter, retrospective coho...
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2025-07-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-11205-w |
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| author | Sheng-Huei Wang Yu-Chao Lin Ming-Cheng Chan Kuang-Yao Yang Chau-Chyun Sheu Biing-Ru Wu Wei-Hsuan Huang Jia-Yih Feng Chia-Min Chen Zi-Xeng Weng Chung-Kan Peng Shih-En Tang and the T-CARE (Taiwan Critical Care and Infection) Group |
| author_facet | Sheng-Huei Wang Yu-Chao Lin Ming-Cheng Chan Kuang-Yao Yang Chau-Chyun Sheu Biing-Ru Wu Wei-Hsuan Huang Jia-Yih Feng Chia-Min Chen Zi-Xeng Weng Chung-Kan Peng Shih-En Tang and the T-CARE (Taiwan Critical Care and Infection) Group |
| author_sort | Sheng-Huei Wang |
| collection | DOAJ |
| description | Abstract Background In this study, we aimed to evaluate the efficacy of cefoperazone-sulbactam-containing (CSC) combination therapy for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections (BSI) patients in intensive care unit (ICU). Methods This multicenter, retrospective cohort study initially included 407 patients with CRAB BSI in the ICU between 2015 and 2019. Patients were divided into the CSC- and non-cefoperazone-sulbactam-containing (NCSC) groups. Outcomes including mortality, clinical failure, and microbiological eradication were compared after time-window bias adjustment and propensity score matching. Results There was no statistical difference in baseline characteristics and disease severity between the CSC (n = 50) and NCSC groups (n = 150) after propensity score matching. The CSC group had significantly lower rates of all-cause mortality (30.0% vs. 50.0%, p = 0.014) and clinical failure (32.0% vs. 52.0%, p = 0.015) on day 28 than the NCSC group. The CSC regimen was an independent protective factor against 28-day clinical failure (adjusted odds ratio (aOR) = 0.281, 95% confidence interval [CI] = 0.091–0.864, p = 0.027). Kaplan–Meier analysis showed that the CSC group had a significantly longer survival time than the NCSC group (log-rank test, p = 0.028). The subgroup analysis of clinical factors associated with 28-day mortality showed that female patients and those with body mass index > 25, non-smoker status, and C-reactive protein < 30 especially favored the CSC regimen instead of the NCSC regimen. Conclusions As an alternative to ampicillin-sulbactam, cefoperazone-sulbactam could be considered as components of combination therapy for critically ill patients with CRAB BSI. |
| format | Article |
| id | doaj-art-daf1cedfdf5a449a984e69b22f438b0a |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-daf1cedfdf5a449a984e69b22f438b0a2025-08-20T03:37:19ZengBMCBMC Infectious Diseases1471-23342025-07-0125111110.1186/s12879-025-11205-wEfficacy of cefoperazone-sulbactam as a component of combination therapy for carbapenem-resistant Acinetobacter baumannii bloodstream infection in intensive care units: a multicenter retrospective propensity score-matched studySheng-Huei Wang0Yu-Chao Lin1Ming-Cheng Chan2Kuang-Yao Yang3Chau-Chyun Sheu4Biing-Ru Wu5Wei-Hsuan Huang6Jia-Yih Feng7Chia-Min Chen8Zi-Xeng Weng9Chung-Kan Peng10Shih-En Tang11and the T-CARE (Taiwan Critical Care and Infection) GroupDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University HospitalDepartment of Critical Care Medicine, Taichung Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University HospitalDivision of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDepartment of Medical Research, Tri-Service General Hospital, National Defense Medical CenterDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterAbstract Background In this study, we aimed to evaluate the efficacy of cefoperazone-sulbactam-containing (CSC) combination therapy for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections (BSI) patients in intensive care unit (ICU). Methods This multicenter, retrospective cohort study initially included 407 patients with CRAB BSI in the ICU between 2015 and 2019. Patients were divided into the CSC- and non-cefoperazone-sulbactam-containing (NCSC) groups. Outcomes including mortality, clinical failure, and microbiological eradication were compared after time-window bias adjustment and propensity score matching. Results There was no statistical difference in baseline characteristics and disease severity between the CSC (n = 50) and NCSC groups (n = 150) after propensity score matching. The CSC group had significantly lower rates of all-cause mortality (30.0% vs. 50.0%, p = 0.014) and clinical failure (32.0% vs. 52.0%, p = 0.015) on day 28 than the NCSC group. The CSC regimen was an independent protective factor against 28-day clinical failure (adjusted odds ratio (aOR) = 0.281, 95% confidence interval [CI] = 0.091–0.864, p = 0.027). Kaplan–Meier analysis showed that the CSC group had a significantly longer survival time than the NCSC group (log-rank test, p = 0.028). The subgroup analysis of clinical factors associated with 28-day mortality showed that female patients and those with body mass index > 25, non-smoker status, and C-reactive protein < 30 especially favored the CSC regimen instead of the NCSC regimen. Conclusions As an alternative to ampicillin-sulbactam, cefoperazone-sulbactam could be considered as components of combination therapy for critically ill patients with CRAB BSI.https://doi.org/10.1186/s12879-025-11205-wCarbapenem-resistant Acinetobacter baumanniiCefoperazone-sulbactamBloodstream infectionClinical failureMortality |
| spellingShingle | Sheng-Huei Wang Yu-Chao Lin Ming-Cheng Chan Kuang-Yao Yang Chau-Chyun Sheu Biing-Ru Wu Wei-Hsuan Huang Jia-Yih Feng Chia-Min Chen Zi-Xeng Weng Chung-Kan Peng Shih-En Tang and the T-CARE (Taiwan Critical Care and Infection) Group Efficacy of cefoperazone-sulbactam as a component of combination therapy for carbapenem-resistant Acinetobacter baumannii bloodstream infection in intensive care units: a multicenter retrospective propensity score-matched study BMC Infectious Diseases Carbapenem-resistant Acinetobacter baumannii Cefoperazone-sulbactam Bloodstream infection Clinical failure Mortality |
| title | Efficacy of cefoperazone-sulbactam as a component of combination therapy for carbapenem-resistant Acinetobacter baumannii bloodstream infection in intensive care units: a multicenter retrospective propensity score-matched study |
| title_full | Efficacy of cefoperazone-sulbactam as a component of combination therapy for carbapenem-resistant Acinetobacter baumannii bloodstream infection in intensive care units: a multicenter retrospective propensity score-matched study |
| title_fullStr | Efficacy of cefoperazone-sulbactam as a component of combination therapy for carbapenem-resistant Acinetobacter baumannii bloodstream infection in intensive care units: a multicenter retrospective propensity score-matched study |
| title_full_unstemmed | Efficacy of cefoperazone-sulbactam as a component of combination therapy for carbapenem-resistant Acinetobacter baumannii bloodstream infection in intensive care units: a multicenter retrospective propensity score-matched study |
| title_short | Efficacy of cefoperazone-sulbactam as a component of combination therapy for carbapenem-resistant Acinetobacter baumannii bloodstream infection in intensive care units: a multicenter retrospective propensity score-matched study |
| title_sort | efficacy of cefoperazone sulbactam as a component of combination therapy for carbapenem resistant acinetobacter baumannii bloodstream infection in intensive care units a multicenter retrospective propensity score matched study |
| topic | Carbapenem-resistant Acinetobacter baumannii Cefoperazone-sulbactam Bloodstream infection Clinical failure Mortality |
| url | https://doi.org/10.1186/s12879-025-11205-w |
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