Clinical Characteristics and Outcomes of Bloodstream Infections Caused by Metallo-β-Lactamase-Producing Enterobacterales in Argentina: A Subanalysis of the EMBARCAR Prospective Multicenter Cohort Study.

Background: Bloodstream infections (BSI) caused by metallo-beta-lactamase (MBL)-producing Enterobacterales (E) are associated with high mortality. However, in most Latin American countries there is a lack of clinical and microbiological data on BSI caused by MBL-E. Methods: This preplanned subgroup analysis of the multicenter, observational, prospective EMBARCAR study focused on adult patients with BSI caused by MBL-E in Argentina. Logistic regression adjusted by propensity scores (PS) for the treatment with ceftazidime-avibactam plus aztreonam (CAZ/AVI plus ATM) were used to identify variables associated with mortality. Results: A total of 140 patients with BSI caused by MBL-producing Enterobacterales were included. Median age was 59 years (IQR 46-70), and most patients were male (61%). Most frequent comorbidities were diabetes 23%, class III obesity 19%, and chronic renal failure 19%. Two thirds of patients were hospitalized in critical care units, 60% required mechanical ventilation and 38% presented with shock. Most frequent isolated microorganisms were Conclusions: In summary, BSI due to MBL-producing Enterobacterales resulted in a high mortality rate in our country. The use of CAZ/AVI plus ATM was associated with a decreased mortality. Better access to these antibiotics should be granted.