Association Between Minimum Inhibitory Concentration, Beta-lactamase Genes and Mortality for Patients Treated With Piperacillin/Tazobactam or Meropenem From the MERINO Study-Reference-Cited by-同舟云学术

Association Between Minimum Inhibitory Concentration, Beta-lactamase Genes and Mortality for Patients Treated With Piperacillin/Tazobactam or Meropenem From the MERINO Study

Published:2020-10-27 Issue:11 Volume:73 Page:e3842-e3850
ISSN:1058-4838
Container-title:Clinical Infectious Diseases
language:en
Short-container-title:

Author:

Henderson A¹²^ORCID,Paterson D L¹,Chatfield M D¹,Tambyah P A³,Lye D C⁴⁵⁶,De P P⁷,Lin R T P⁷,Chew K L⁸,Yin M³,Lee T H⁴⁵⁶,Yilmaz M⁹,Cakmak R⁹,Alenazi T H¹⁰,Arabi Y M¹⁰,Falcone M¹¹,Bassetti M¹²,Righi E¹³¹⁴,Rogers B A¹⁵¹⁶,Kanj S S¹⁷,Bhally H¹⁸,Iredell J¹⁹²⁰,Mendelson M²¹,Boyles T H²¹,Looke D F M²²²,Runnegar N J²²²,Miyakis S²³²⁴²⁵,Walls G²⁶,Khamis M A I²⁷,Zikri A²⁷,Crowe A²⁸²⁹,Ingram P R³⁰³¹³²,Daneman N³³,Griffin P²²³⁴³⁵,Athan E³⁶,Roberts L³⁷,Beatson S A³⁷,Peleg A Y³⁸³⁹,Cottrell K¹,Bauer M J¹,Tan E¹,Chaw K⁴⁰⁴¹⁴²,Nimmo G R⁴³,Harris-Brown T¹,Harris P N A¹⁴³,Newton Peter,Wren Heather,Graham Maryza,Korman Tony,Aljohani Sameera M,Alalwan Bassam,Sultana Khizra,Sartor Assunta,Welch Darren,Kahlmeter Gunnar,

Affiliation:

1. University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia

2. Infection Management Services, Princess Alexandra Hospital, Brisbane, Australia

3. Department of Infectious Diseases, National University Hospital, Singapore

4. Yong Loo Lin School of Medicine, National University of Singapore, Singapore

5. Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore

6. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore

7. Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore

8. Division of Microbiology, National University Hospital, Singapore

9. Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey

10. King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia

11. Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Pisa, Italy

12. Infectious Diseases Clinic, Department of Health Sciences, University of Genoa and Ospedale Policlinico San Martino Genoa, Italy

13. Infectious Diseases Clinic, Department of Medicine University of Udine and Santa Maria Misericordia Hospital, Udine, Italy

14. Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy

15. Monash University, Centre for Inflammatory Diseases, Victoria, Australia

16. Monash Infectious Diseases, Monash Health, Victoria, Australia

17. Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon

18. Department of Medicine and Infectious Diseases, North Shore Hospital, Auckland, New Zealand

19. Marie Bashir Institute for Infectious Disease and Biosecurity, University of Sydney, Sydney, Australia

20. Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, Australia

21. Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa

22. University of Queensland, Brisbane, Australia

23. School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia

24. Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia

25. Department of Infectious Diseases, Wollongong Hospital, Wollongong, New South Wales, Australia

26. Department of Infectious Diseases, Middlemore Hospital, Auckland, New Zealand

27. King Fahad Specialist Hospital, Dammam, Saudi Arabia

28. Department of Infectious Diseases, St Vincent's Hospital, Melbourne, Australia

29. Department of Microbiology, St Vincent's Hospital, Melbourne, Australia

30. School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Australia

31. Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, Australia

32. Department of Microbiology, PathWest Laboratory Medicine, Perth, Western Australia

33. Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada

34. Department of Medicine and Infectious Diseases, Mater Hospital and Mater Medical Research Institute, Brisbane, Australia

35. QIMR Berghofer, Brisbane, Queensland, Australia

36. Department of Infectious Diseases, Barwon Health and Deakin University, Geelong, Victoria, Australia

37. Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, University of Queensland, Queensland, Australia

38. Infection & Immunity Program, Biomedicine Discovery Institute, Monash University, Clayton, Australia

39. Department of Microbiology, Monash University, Clayton, Australia

40. Department of Microbiology, Pathology Queensland, Toowoomba Laboratory, Australia

41. Department of Microbiology, Mater Pathology, Australia

42. Infectious Diseases Department, Redcliffe Hospital, Australia

43. Department of Microbiology, Pathology Queensland, Royal Brisbane and Women’s Hospital, Brisbane, Australia

Abstract

Abstract Introduction This study aims to assess the association of piperacillin/tazobactam and meropenem minimum inhibitory concentration (MIC) and beta-lactam resistance genes with mortality in the MERINO trial. Methods Blood culture isolates from enrolled patients were tested by broth microdilution and whole genome sequencing at a central laboratory. Multivariate logistic regression was performed to account for confounders. Absolute risk increase for 30-day mortality between treatment groups was calculated for the primary analysis (PA) and the microbiologic assessable (MA) populations. Results In total, 320 isolates from 379 enrolled patients were available with susceptibility to piperacillin/tazobactam 94% and meropenem 100%. The piperacillin/tazobactam nonsusceptible breakpoint (MIC >16 mg/L) best predicted 30-day mortality after accounting for confounders (odds ratio 14.9, 95% confidence interval [CI] 2.8–87.2). The absolute risk increase for 30-day mortality for patients treated with piperacillin/tazobactam compared with meropenem was 9% (95% CI 3%–15%) and 8% (95% CI 2%–15%) for the original PA population and the post hoc MA populations, which reduced to 5% (95% CI −1% to 10%) after excluding strains with piperacillin/tazobactam MIC values >16 mg/L. Isolates coharboring extended spectrum β-lactamase (ESBL) and OXA-1 genes were associated with elevated piperacillin/tazobactam MICs and the highest risk increase in 30-day mortality of 14% (95% CI 2%–28%). Conclusions After excluding nonsusceptible strains, the 30-day mortality difference from the MERINO trial was less pronounced for piperacillin/tazobactam. Poor reliability in susceptibility testing performance for piperacillin/tazobactam and the high prevalence of OXA coharboring ESBLs suggests that meropenem remains the preferred choice for definitive treatment of ceftriaxone nonsusceptible Escherichia coli and Klebsiella.

Funder

Study Education and Research Committee of Pathology Queensland

Australian Infectious Disease Centre and Australian Genome Research Facility

Royal College of Pathologists of Australasia Foundation

National Health and Medical Research Council

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Link

http://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciaa1479/34559079/ciaa1479.pdf

Reference27 articles.