METHODS: This is a single-centre retrospective cohort study of patients admitted between January 1, 2018 and June 30, 2021 with the diagnosis of CRKP infections receiving either CAZ-AVI or other regimens ≥ 72 hours and clinical outcomes were analysed.
RESULTS: Of 200 patients with CRKP infections, 67 received CAZ-AVI, 133 received other regimens, and 50 were SOT recipients. In the SOT cohort, 30 patients received CAZ-AVI, and 20 received other regimens. The overall 30-day mortality was 38% in the SOT cohort. Compared with patients receiving other regimens, CAZ-AVI therapy resulted in lower 30-day mortality (23.3% vs. 60%, P = 0.014) and 90-day mortality (35.7% vs. 86.7%, P = 0.003), higher clinical cure (93.3% vs. 40%, P < 0.001) and microbiological clearance. Similar promising results of CAZ-AVI were also shown in the whole population cohort. Moreover, clinical outcomes of SOT recipients receiving CAZ-AVI were not inferior to those without SOT.
CONCLUSIONS: CAZ-AVI therapy was associated with better clinical outcomes in CRKP infections in both the general population and SOT recipients. Considering the limitations of the present study, well-conducted RCTs are still warranted to confirm these findings.
方法:这是一项单中心回顾性队列研究,研究对象为2018年1月1日至2021年6月30日收治的诊断为CRKP感染的患者,接受CAZ-AVI或其他方案≥72小时,并分析临床结果。
结果:在200例CRKP感染患者中,67收到CAZ-AVI,133人接受了其他治疗方案,50个是SOT接受者。在SOT队列中,30例患者接受CAZ-AVI,20人接受了其他方案。在SOT队列中,30天的总死亡率为38%。与接受其他治疗方案的患者相比,CAZ-AVI治疗可降低30天死亡率(23.3%vs.60%,p=0.014)和90天死亡率(35.7%vs.86.7%,p=0.003),更高的临床治愈率(93.3%vs.40%,p<0.001)和微生物清除率。CAZ-AVI的类似有希望的结果也显示在整个群体队列中。此外,接受CAZ-AVI的SOT受者的临床结局不亚于没有接受SOT的受者.
结论:CAZ-AVI治疗与一般人群和SOT受者CRKP感染的更好临床结局相关。考虑到本研究的局限性,仍有必要进行良好的RCT来证实这些发现.