Comparison of colistin-carbapenem, colistin-sulbactam, and colistin plus other antibacterial agents for the treatment of extremely drug-resistant Acinetobacter baumannii bloodstream infections

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dc.authoridaltay, fatma aybala -- 0000-0002-7149-2968; Karabay, Oguz -- 0000-0003-0502-432X; Durdu, Bulent -- 0000-0002-0244-4006en_US
dc.contributor.authorBatirel, A.
dc.contributor.authorBalkan, I. I.
dc.contributor.authorKarabay, O.
dc.contributor.authorAgalar, C.
dc.contributor.authorAkalin, S.
dc.contributor.authorAlici, O.
dc.contributor.authorAlp, E.
dc.contributor.authorAltay, F. A.
dc.contributor.authorAltin, N.
dc.contributor.authorArslan, F.
dc.contributor.authorAslan, T.
dc.contributor.authorBekiroglu, N.
dc.contributor.authorCesur, S.
dc.contributor.authorCelik, A. D.
dc.contributor.authorDogan, M.
dc.contributor.authorDurdu, B.
dc.contributor.authorDuygu, F.
dc.contributor.authorEngin, A.
dc.contributor.authorEngin, D. O.
dc.contributor.authorGonen, I.
dc.contributor.authorGuclu, E.
dc.contributor.authorGuven, T.
dc.contributor.authorHatipoglu, C. A.
dc.contributor.authorHosoglu, S.
dc.contributor.authorKarahocagil, M. K.
dc.contributor.authorKilic, A. U.
dc.contributor.authorOrmen, B.
dc.contributor.authorOzdemir, D.
dc.contributor.authorOzer, S.
dc.contributor.authorOztoprak, N.
dc.contributor.authorSezak, N.
dc.contributor.authorTurhan, V.
dc.contributor.authorTurker, N.
dc.contributor.authorYilmaz, H.
dc.date.accessioned2019-07-27T12:10:23Z
dc.date.accessioned2019-07-28T09:57:04Z
dc.date.available2019-07-27T12:10:23Z
dc.date.available2019-07-28T09:57:04Z
dc.date.issued2014
dc.department[Batirel, A. -- Ozer, S.] Kartal Dr Lutfi Kirdar Educ & Res Hosp, TR-34890 Istanbul, Turkey -- [Balkan, I. I.] Istanbul Univ, Cerrahpasa Med Fac, Istanbul, Turkey -- [Karabay, O. -- Guclu, E.] Sakarya Univ, Fac Med, Sakarya, Turkey -- [Agalar, C. -- Alici, O.] Fatih Sultan Mehmet Educ & Res Hosp, Istanbul, Turkey -- [Akalin, S.] Pamukkale Univ, Fac Med, Denizli, Turkey -- [Alp, E. -- Kilic, A. U.] Erciyes Univ, Fac Med, Kayseri, Turkey -- [Altay, F. A.] Diskapi Educ & Res Hosp, Ankara, Turkey -- [Altin, N. -- Cesur, S.] Ankara Etlik Educ & Res Hosp, Ankara, Turkey -- [Arslan, F.] Istanbul Medipol Univ, Fac Med, Istanbul, Turkey -- [Aslan, T.] Bezmi Alem Univ, Fac Med, Istanbul, Turkey -- [Bekiroglu, N.] Marmara Univ, Fac Med, Istanbul, Turkey -- [Celik, A. D.] Trakya Univ, Fac Med, Edirne, Turkey -- [Dogan, M.] Namik Kemal Univ, Fac Med, Tekirdag, Turkey -- [Durdu, B.] Bakirkoy Sadi Konuk Educ & Res Hosp, Istanbul, Turkey -- [Duygu, F.] Gaziosmanpasa Univ, Fac Med, Tokat, Turkey -- [Engin, A.] Cumhuriyet Univ, Fac Med, Sivas, Turkey -- [Engin, D. O.] Haydarpasa Numune Educ & Res Hosp, Istanbul, Turkey -- [Gonen, I.] Suleyman Demirel Univ, Fac Med, TR-32200 Isparta, Turkey -- [Guven, T.] Ankara Ataturk Educ & Res Hosp, Ankara, Turkey -- [Hatipoglu, C. A.] Ankara Educ & Res Hosp, Ankara, Turkey -- [Hosoglu, S.] Dicle Univ, Fac Med, Diyarbakir, Turkey -- [Karahocagil, M. K.] Yuzuncu Yil Univ, Fac Med, Van, Turkey -- [Ormen, B.] Izmir Ataturk Educ & Res Hosp, Izmir, Turkey -- [Ozdemir, D. -- Sezak, N. -- Turker, N.] Duzce Univ, Educ & Res Hosp, Duzce, Turkey -- [Oztoprak, N.] Antalya Educ & Res Hosp, Antalya, Turkey -- [Turhan, V.] GATA Haydarpasa Educ & Res Hosp, Istanbul, Turkey -- [Yilmaz, H.] Ondokuz Mayis Univ, Fac Med, Samsun, Turkeyen_US
dc.description23rd European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) -- 41394 -- Berlin, GERMANYen_US
dc.description.abstractThe purpose of this investigation was to compare the efficacy of colistin-based therapies in extremely drug-resistant Acinetobacter spp. bloodstream infections (XDR-ABSI). A retrospective study was conducted in 27 tertiary-care centers from January 2009 to August 2012. The primary end-point was 14-day survival, and the secondary end-points were clinical and microbiological outcomes. Thirty-six and 214 patients [102 (47.7 %): colistin-carbapenem (CC), 69 (32.2 %): colistin-sulbactam (CS), and 43 (20.1 %: tigecycline): colistin with other agent (CO)] received colistin monotherapy and colistin-based combinations, respectively. Rates of complete response/cure and 14-day survival were relatively higher, and microbiological eradication was significantly higher in the combination group. Also, the in-hospital mortality rate was significantly lower in the combination group. No significant difference was found in the clinical (p = 0.97) and microbiological (p = 0.92) outcomes and 14-day survival rates (p = 0.79) between the three combination groups. Neither the timing of initial effective treatment nor the presence of any concomitant infection was significant between the three groups (p > 0.05) and also for 14-day survival (p > 0.05). Higher Pitt bacteremia score (PBS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Charlson comorbidity index (CCI), and prolonged hospital and intensive care unit (ICU) stay before XDR-ABSI were significant risk factors for 14-day mortality (p = 0.02, p = 0.0001, p = 0.0001, p = 0.02, and p = 0.01, respectively). In the multivariable analysis, PBS, age, and duration of ICU stay were independent risk factors for 14-day mortality (p < 0.0001, p < 0.0001, and p = 0.001, respectively). Colistin-based combination therapy resulted in significantly higher microbiological eradication rates, relatively higher cure and 14-day survival rates, and lower in-hospital mortality compared to colistin monotherapy. CC, CS, and CO combinations for XDR-ABSI did not reveal significant differences with respect to 14-day survival and clinical or microbiological outcome before and after propensity score matching (PSM). PBS, age, and length of ICU stay were independent risk factors for 14-day mortality.en_US
dc.identifier.doi10.1007/s10096-014-2070-6en_US
dc.identifier.endpage1322en_US
dc.identifier.issn0934-9723
dc.identifier.issn1435-4373
dc.identifier.issue8en_US
dc.identifier.pmid24532009en_US
dc.identifier.scopus2-s2.0-84903819291en_US
dc.identifier.scopusqualityQ1
dc.identifier.startpage1311en_US
dc.identifier.urihttps://dx.doi.org/10.1007/s10096-014-2070-6
dc.identifier.urihttps://hdl.handle.net/20.500.12418/8212
dc.identifier.volume33en_US
dc.identifier.wosWOS:000338723600006en_US
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSPRINGERen_US
dc.relation.ispartofEUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASESen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.titleComparison of colistin-carbapenem, colistin-sulbactam, and colistin plus other antibacterial agents for the treatment of extremely drug-resistant Acinetobacter baumannii bloodstream infectionsen_US
dc.typeArticleen_US

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