%0 Multicenter Study
%T Evaluation of clinical and microbiological factors related to mortality in patients with Gram-negative bacterial infections treated with ceftazidime-avibactam: A prospective multicentric cohort study.
%A Arns B
%A Sorio GGL
%A Vieceli T
%A Pereira D
%A Celestino de Souza Â
%A Lamb Wink P
%A Paes JH
%A David L
%A Barboza F
%A Hickmann S
%A Alves G
%A Santos AC
%A da Rosa A
%A Duarte Alves M
%A Massotti Magagnin C
%A Gomes E
%A Zavascki AP
%A Rigatto MH
%J J Glob Antimicrob Resist
%V 36
%N 0
%D 2024 Mar 9
%M 38342378
%F 4.349
%R 10.1016/j.jgar.2024.02.001
%X <B>OBJECTIVE: </B>This study aimed to evaluate the clinical and microbiological risk factors associated with mortality in patients treated with ceftazidime-avibactam for carbapenem-resistant Gram-negative bacterial infections.<BR><B>METHODS: </B>This multicentric prospective cohort study included hospitalized adult patients with a microbiologically confirmed infection treated with ceftazidime-avibactam for ≥48 hours. The clinical and microbiological risk factors for 30-day mortality were evaluated using a Cox regression model.<BR><B>RESULTS: </B>Of the 193 patients evaluated from the five tertiary hospitals, 127 were included in the study. Thirty-five patients (27.6%) died within 30 days. Infections with AmpC beta-lactamase-carrying bacteria were independently related to 30-day mortality (adjusted hazard ratio [aHR] 2.49, 95% confidence interval [CI] 1.28-4.84, P < 0.01) after adjusting for time from infection to antimicrobial prescription (P = 0.04). Further, these bacterial infections were also related to higher in-hospital mortality (aHR 2.17, 95% CI 1.24-3.78, P < 0.01). Only one patient developed resistance to ceftazidime-avibactam during treatment.<BR><B>CONCLUSIONS: </B>Treatment with ceftazidime-avibactam had worse clinical outcomes in patients with infections with bacteria with chromosomally encoded AmpC beta-lactamase. However, these findings should be confirmed in future studies.