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Abstract：
OBJECTIVE: This case series describes real-world utilization of cefiderocol and associated clinical outcomes in the setting of carbapenem-resistant Gram-negative bacterial infections.
METHODS: Adult hospitalized patients administered at least 5 days of cefiderocol as definitive treatment from October 1, 2020 to September 16, 2021 were included in this retrospective cohort analysis. The primary outcome was clinical success defined as a composite of 30 day survival, resolution of infection, and absence of 30 day recurrence of the same organism.
RESULTS: Among 24 patients, pneumonia (19, 79%) was the most common source of infection with Acinetobacter baumannii (14, 58%) and P. aeruginosa (10, 42%) as the predominant organisms isolated. Cefiderocol monotherapy was used as definitive treatment in 16 (67%) patients. Eleven patients (46%) met clinical success. Thirty-day mortality occurred in ten (42%) patients while seven (29%) patients had recurrence of infection. Thirteen out of 21 total isolates (62%) tested for susceptibility were deemed susceptible. Of the 16 patients with available susceptibility, 9 (56%) had an infection where all isolated organisms were susceptible to cefiderocol.
CONCLUSIONS: Our results provide additional insight into the in vivo activity of cefiderocol. Cefiderocol remains a salvage option for carbapenem-resistant Gram-negative organisms.
METHODS: Adult hospitalized patients administered at least 5 days of cefiderocol as definitive treatment from October 1, 2020 to September 16, 2021 were included in this retrospective cohort analysis. The primary outcome was clinical success defined as a composite of 30 day survival, resolution of infection, and absence of 30 day recurrence of the same organism.
RESULTS: Among 24 patients, pneumonia (19, 79%) was the most common source of infection with Acinetobacter baumannii (14, 58%) and P. aeruginosa (10, 42%) as the predominant organisms isolated. Cefiderocol monotherapy was used as definitive treatment in 16 (67%) patients. Eleven patients (46%) met clinical success. Thirty-day mortality occurred in ten (42%) patients while seven (29%) patients had recurrence of infection. Thirteen out of 21 total isolates (62%) tested for susceptibility were deemed susceptible. Of the 16 patients with available susceptibility, 9 (56%) had an infection where all isolated organisms were susceptible to cefiderocol.
CONCLUSIONS: Our results provide additional insight into the in vivo activity of cefiderocol. Cefiderocol remains a salvage option for carbapenem-resistant Gram-negative organisms.
摘要：
目的：本病例系列描述了在碳青霉烯类耐药的革兰氏阴性菌感染中头孢地洛的实际应用和相关临床结果。
方法：本回顾性队列分析包括2020年10月1日至2021年9月16日给予头孢地洛至少5天作为确定性治疗的成年住院患者。主要结果是临床成功定义为30天生存的复合，感染的解决，并且没有相同生物体的30天复发。
结果：在24名患者中，肺炎（19，79％）是最常见的感染源，鲍曼不动杆菌（14，58％）和铜绿假单胞菌（10，42％）是分离的主要生物。头孢地洛单药治疗16例（67％）患者被用作确定性治疗。11名患者（46％）达到临床成功。10例（42％）患者死亡30天，而7例（29％）患者感染复发。在经过敏感性测试的21个分离株中，有13个（62％）被认为是易感的。在16名具有易感性的患者中，9（56％）感染了所有分离的生物都对头孢地洛敏感。
结论：我们的结果为头孢地洛的体内活性提供了更多的见解。头孢地洛仍然是耐碳青霉烯类革兰氏阴性菌的挽救选择。
方法：本回顾性队列分析包括2020年10月1日至2021年9月16日给予头孢地洛至少5天作为确定性治疗的成年住院患者。主要结果是临床成功定义为30天生存的复合，感染的解决，并且没有相同生物体的30天复发。
结果：在24名患者中，肺炎（19，79％）是最常见的感染源，鲍曼不动杆菌（14，58％）和铜绿假单胞菌（10，42％）是分离的主要生物。头孢地洛单药治疗16例（67％）患者被用作确定性治疗。11名患者（46％）达到临床成功。10例（42％）患者死亡30天，而7例（29％）患者感染复发。在经过敏感性测试的21个分离株中，有13个（62％）被认为是易感的。在16名具有易感性的患者中，9（56％）感染了所有分离的生物都对头孢地洛敏感。
结论：我们的结果为头孢地洛的体内活性提供了更多的见解。头孢地洛仍然是耐碳青霉烯类革兰氏阴性菌的挽救选择。
