ArticlePloS one2018
Carbapenem-resistant Gram-negative pathogens in a German university medical center: Prevalence, clinical implications and the role of novel β-lactam/β-lactamase inhibitor combinations.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Ceftazidime with avibactam for treating severe aerobic Gram-negative bacterial infections: technology evaluation to inform a novel subscription-style payment model.Health technology assessment (Winchester, England) · 2024Pooled it
- Prevalence of colistin resistance in clinical isolates ofFrontiers in microbiology · 2024Pooled it
- Adaptation and performance evaluation of the French society of microbiology algorithm for detection of carbapenemase-producing enterobacterales using VITEK2 antibiotic susceptibility testing system.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Ceftazidime/Avibactam Monotherapy Versus Other Antibiotics: Where Do We Stand?Pathogens (Basel, Switzerland) · 2025Review
- Feasibility analysis of pharmacy practice based on the evidence-based pharmacy model in the treatment of patients with severe pneumonia.Pakistan journal of medical sciences · 2025Article
- Beyond the Spotlight:Antibiotics (Basel, Switzerland) · 2025Review
- In Vitro Activity of Cefaclor/Beta-Lactamases Inhibitors (Clavulanic Acid and Sulbactam) Combination Against Extended-Spectrum Beta-Lactamase Producing UropathogenicAntibiotics (Basel, Switzerland) · 2025Article
- Infective endocarditis by carbapenem-resistant Gram-negative bacteria - a systematic review.Germs · 2024Review
- Extended and Continuous Infusion of Novel Protected β-Lactam Antibiotics: A Narrative Review.Drugs · 2023Review
- Study of Antimicrobial Resistance, Biofilm Formation, and Motility ofMicroorganisms · 2023Article
- Trends in Antibiotic Resistance of Nosocomial and Community-Acquired Infections in Italy.Antibiotics (Basel, Switzerland) · 2023Article
- Clinical and Molecular Profile of Carbapenem ResistantInfection and drug resistance · 2023Article
- First report of a carbapenemase OXA-48-producingAccess microbiology · 2023Article
- Molecular epidemiology, risk factors, and outcomes of carbapenem-resistantFrontiers in microbiology · 2023Article
- Phenotypic and genotypic detection of resistance mechanisms in carbapenem-resistant gram-negative bacteria isolated from Egyptian ICU patients with first emergence of NDM-1 producingIranian journal of microbiology · 2022Article
- An 18-Year Dataset on the Clinical Incidence and MICs to Antibiotics ofAntibiotics (Basel, Switzerland) · 2022Article
- Ceftazidime-Avibactam for the Treatment of Serious Gram-Negative Infections with Limited Treatment Options: A Systematic Literature Review.Infectious diseases and therapy · 2021Review
- Clinical management of cUTI, cIAI, and HABP/VABP attributable to carbapenem-resistant Gram-negative infections in Spain.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021Article
- Epidemiology and infection control of carbapenem resistant Acinetobacter baumannii and Klebsiella pneumoniae at a German university hospital: a retrospective study of 5 years (2015-2019).BMC infectious diseases · 2021Article
- WGS based analysis of acquired antimicrobial resistance in human and non-human Acinetobacter baumannii isolates from a German perspective.BMC microbiology · 2021Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine the spectrum of infections with multidrug-resistant Gram-negative bacteria (MDR-GNB) and the clinical impact of the newly available betalactam/betalactamase inhibitor combinations ceftolozane/tazobactam and ceftazidime/avibactam in a German academic tertiary care center.
methodsRetrospective analysis.
resultsBetween September 1, 2015 and August 31, 2016, 119 individual patients (0.22% of all hospital admissions) were colonized or infected with carbapenem-resistant MDR-GNB. The species distribution was Pseudomonas aeruginosa, n = 66; Enterobacteriaceae spp., n = 44; and Acinetobacter baumannii, n = 18. In 9 patients, carbapenem-resistant isolates belonging to more than one species were detected. Infection was diagnosed in 50 patients (total: 42.0%; nosocomial pneumonia: n = 23, 19.3%; bloodstream infection: n = 11, 9.2%). Antimicrobial treatment with broad-spectrum antibiotics prior to detection of a carbapenem-resistant isolate was documented in 105 patients (88.2%, prior administration of carbapenems: 62.2%). Nosocomial transmission was documented in 29 patients (24.4%). In 26 patients (21.8%), at least one carbapenem-susceptible, third-generation cephalosporin non-susceptible isolate was documented prior to detection of a carbapenem-resistant isolate belonging to the same species (median 38 days, IQR 23-78). 12 patients (10.1%) had documented previous contact to the healthcare system in a country with high burden of carbapenemase-producing strains. Genes encoding carbapenemases were detected in 60/102 patient isolates (58.8%; VIM-2, n = 25; OXA-48, n = 21; OXA-23-like, n = 10). Susceptibility to colistin was 94.3%. Ceftolozane/tazobactam and ceftazidime/avibactam were administered to 3 and 5 patients, respectively (in-hospital mortality: 66% and 100%). Development of drug-resistance under therapy was observed for both antimicrobials.
conclusionsi) The major predisposing factors for acquisition of carbapenem-resistant MDR-GNB were selective pressure due to preceding antimicrobial therapy and nosocomial transmission. ii) Colistin remains the backbone of antimicrobial chemotherapy for infections caused by carbapenem-resistant MDR-GNB. iii) Novel β-lactam/β-lactamase inhibitor combinations are of limited usefulness in our setting because of the high prevalence of Ambler class B carbapenemases and the emergence of nonsusceptibility under therapy.
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