A Systems-Based Analysis of Mono- and Combination Therapy for Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infections

Author:

Luterbach Courtney L.12,Qiu Hongqiang13ORCID,Hanafin Patrick O.1,Sharma Rajnikant1,Piscitelli Joseph1,Lin Feng-Chang4,Ilomaki Jenni5,Cober Eric6,Salata Robert A.7,Kalayjian Robert C.8,Watkins Richard R.9,Doi Yohei1011ORCID,Kaye Keith S.12,Nation Roger L.13,Bonomo Robert A.14151617ORCID,Landersdorfer Cornelia B.13ORCID,van Duin David18ORCID,Rao Gauri G.1ORCID

Affiliation:

1. Division of Pharmaceutics and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA

2. Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA

3. Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China

4. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA

5. Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia

6. Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA

7. Division of Infectious Diseases and HIV Medicine, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

8. Department of Medicine, MetroHealth Medical Center, Cleveland, Ohio, USA

9. Department of Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA

10. Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

11. Departments of Microbiology and Infectious Diseases, Fujita Health University School of Medicine, Aichi, Japan

12. Division of Infectious Diseases, University of Michigan, Ann Arbor, Michigan, USA

13. Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia

14. Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA

15. Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

16. Departments of Pharmacology, Molecular Biology and Microbiology, Biochemistry, and Proteomics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

17. CWRU-Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, Ohio, USA

18. Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA

Abstract

Antimicrobial resistance is a global threat. As “proof-of-concept,” we employed a system-based approach to identify patient, bacterial, and drug variables contributing to mortality in patients with carbapenem-resistant Klebsiella pneumoniae (CR Kp ) bloodstream infections exposed to colistin (COL) and ceftazidime-avibactam (CAZ/AVI) as mono- or combination therapies.

Funder

HHS | NIH | National Institute of Allergy and Infectious Diseases

HHS | National Institutes of Health

HHS | NIH | National Institute of General Medical Sciences

Fujian Science and Technology Innovation Joint Project

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

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