Christel Mamona Kilu, Camille Menvielle, Anne Cataldi, Antoine Hamon, Clara Duran, Cedric Mwanba, Chloé Tesmoingt, Laura Bouabdallah-Perrin, Pauline Touche, Aurélie Chanh Hew Wai, Clément Ourghanlian, Marie Antignac, Marc-Antoine Bildan, Alexandre Bleibtreu, Hugues Michelon, Sylvain Diamantis, Benoit Pilmis, Antoine Citerne, Eric Farfour, Aurélien Dinh
{"title":"替莫西林治疗由产 ESBL 肠杆菌引起的非尿路感染的疗效及失败的风险因素。","authors":"Christel Mamona Kilu, Camille Menvielle, Anne Cataldi, Antoine Hamon, Clara Duran, Cedric Mwanba, Chloé Tesmoingt, Laura Bouabdallah-Perrin, Pauline Touche, Aurélie Chanh Hew Wai, Clément Ourghanlian, Marie Antignac, Marc-Antoine Bildan, Alexandre Bleibtreu, Hugues Michelon, Sylvain Diamantis, Benoit Pilmis, Antoine Citerne, Eric Farfour, Aurélien Dinh","doi":"10.1093/jacamr/dlae164","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To describe the real-life use of temocillin for non-urinary tract infections, to assess its effectiveness in infections caused by ESBL-producing Enterobacterales, and to identify risk factors for treatment failure.</p><p><strong>Method: </strong>Retrospective multicentric study in 14 tertiary care hospitals, including all patients who received at least one dose of temocillin for ESBL infections from 1 January 2016 to 31 December 2021 for non-urinary tract infections. Failure was a composite criterion defined within 28 day follow-up by persistence or reappearance of signs of infection, and/or switch to suppressive antibiotic treatment and/or death from infection. Logistic regression with univariable and multivariable analysis was performed to identify risks associated with failure.</p><p><strong>Results: </strong>Data on 163 infection episodes were collected; 133 were due to ESBL-producing Enterobacterales and 128 were included in the effectiveness analysis. Median (IQR) age was 61 (53-70) years and 61.7% of patients were male. Main indications were lower respiratory tract infection (LRTI; 28.9%), intra-abdominal infections (IAI; 28.1%) and cutaneous infections (12.5%). The main bacteria involved were <i>Klebsiella pneumoniae</i> (48.4%), <i>Escherichia coli</i> (25.0%) and <i>Enterobacter cloacae</i> (24.2%). Polymicrobial infections occurred in 45.3% of cases. Temocillin was used as monotherapy in 86/128 (67.2%). Failure was found in 36/128 (28.1%) cases. In multivariable analysis, the only factor associated with failure was initial severity of the episode [adjusted OR 3.0 (95% CI: 1.06-8.69)].</p><p><strong>Conclusions: </strong>During non-urinary tract infections, the main use of temocillin was for LRTIs and IAIs due to ESBL-producing <i>E. coli</i> and <i>K. pneumoniae</i>. The main risk factor for failure was initial severity of the disease.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 5","pages":"dlae164"},"PeriodicalIF":3.7000,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483619/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of temocillin in treatment of non-urinary tract infections caused by ESBL-producing Enterobacterales and risk factors for failure.\",\"authors\":\"Christel Mamona Kilu, Camille Menvielle, Anne Cataldi, Antoine Hamon, Clara Duran, Cedric Mwanba, Chloé Tesmoingt, Laura Bouabdallah-Perrin, Pauline Touche, Aurélie Chanh Hew Wai, Clément Ourghanlian, Marie Antignac, Marc-Antoine Bildan, Alexandre Bleibtreu, Hugues Michelon, Sylvain Diamantis, Benoit Pilmis, Antoine Citerne, Eric Farfour, Aurélien Dinh\",\"doi\":\"10.1093/jacamr/dlae164\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To describe the real-life use of temocillin for non-urinary tract infections, to assess its effectiveness in infections caused by ESBL-producing Enterobacterales, and to identify risk factors for treatment failure.</p><p><strong>Method: </strong>Retrospective multicentric study in 14 tertiary care hospitals, including all patients who received at least one dose of temocillin for ESBL infections from 1 January 2016 to 31 December 2021 for non-urinary tract infections. Failure was a composite criterion defined within 28 day follow-up by persistence or reappearance of signs of infection, and/or switch to suppressive antibiotic treatment and/or death from infection. Logistic regression with univariable and multivariable analysis was performed to identify risks associated with failure.</p><p><strong>Results: </strong>Data on 163 infection episodes were collected; 133 were due to ESBL-producing Enterobacterales and 128 were included in the effectiveness analysis. Median (IQR) age was 61 (53-70) years and 61.7% of patients were male. Main indications were lower respiratory tract infection (LRTI; 28.9%), intra-abdominal infections (IAI; 28.1%) and cutaneous infections (12.5%). The main bacteria involved were <i>Klebsiella pneumoniae</i> (48.4%), <i>Escherichia coli</i> (25.0%) and <i>Enterobacter cloacae</i> (24.2%). Polymicrobial infections occurred in 45.3% of cases. Temocillin was used as monotherapy in 86/128 (67.2%). Failure was found in 36/128 (28.1%) cases. In multivariable analysis, the only factor associated with failure was initial severity of the episode [adjusted OR 3.0 (95% CI: 1.06-8.69)].</p><p><strong>Conclusions: </strong>During non-urinary tract infections, the main use of temocillin was for LRTIs and IAIs due to ESBL-producing <i>E. coli</i> and <i>K. pneumoniae</i>. The main risk factor for failure was initial severity of the disease.</p>\",\"PeriodicalId\":14594,\"journal\":{\"name\":\"JAC-Antimicrobial Resistance\",\"volume\":\"6 5\",\"pages\":\"dlae164\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-10-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483619/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JAC-Antimicrobial Resistance\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/jacamr/dlae164\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAC-Antimicrobial Resistance","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/jacamr/dlae164","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Effectiveness of temocillin in treatment of non-urinary tract infections caused by ESBL-producing Enterobacterales and risk factors for failure.
Objectives: To describe the real-life use of temocillin for non-urinary tract infections, to assess its effectiveness in infections caused by ESBL-producing Enterobacterales, and to identify risk factors for treatment failure.
Method: Retrospective multicentric study in 14 tertiary care hospitals, including all patients who received at least one dose of temocillin for ESBL infections from 1 January 2016 to 31 December 2021 for non-urinary tract infections. Failure was a composite criterion defined within 28 day follow-up by persistence or reappearance of signs of infection, and/or switch to suppressive antibiotic treatment and/or death from infection. Logistic regression with univariable and multivariable analysis was performed to identify risks associated with failure.
Results: Data on 163 infection episodes were collected; 133 were due to ESBL-producing Enterobacterales and 128 were included in the effectiveness analysis. Median (IQR) age was 61 (53-70) years and 61.7% of patients were male. Main indications were lower respiratory tract infection (LRTI; 28.9%), intra-abdominal infections (IAI; 28.1%) and cutaneous infections (12.5%). The main bacteria involved were Klebsiella pneumoniae (48.4%), Escherichia coli (25.0%) and Enterobacter cloacae (24.2%). Polymicrobial infections occurred in 45.3% of cases. Temocillin was used as monotherapy in 86/128 (67.2%). Failure was found in 36/128 (28.1%) cases. In multivariable analysis, the only factor associated with failure was initial severity of the episode [adjusted OR 3.0 (95% CI: 1.06-8.69)].
Conclusions: During non-urinary tract infections, the main use of temocillin was for LRTIs and IAIs due to ESBL-producing E. coli and K. pneumoniae. The main risk factor for failure was initial severity of the disease.