Treatment strategies for OXA-48-like and NDM producing Klebsiella pneumoniae infections

Isler B., Aslan A. T., AKOVA M., Harris P., Paterson D. L.

EXPERT REVIEW OF ANTI-INFECTIVE THERAPY, cilt.20, sa.11, ss.1389-1400, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 20 Sayı: 11
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1080/14787210.2022.2128764
  • Dergi Adı: EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, Chemical Abstracts Core, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.1389-1400
  • Anahtar Kelimeler: OXA-48, NDM, Klebsiella pneumoniae, carbapenem resistant, ceftazidime-avibactam, CARBAPENEMASE-PRODUCING ENTEROBACTERIACEAE, BLOOD-STREAM INFECTIONS, GLOBAL SURVEILLANCE PROGRAM, IN-VITRO SUSCEPTIBILITY, RESISTANT, MORTALITY, COLISTIN, TIGECYCLINE, COMBINATION, BACTEREMIA
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Introduction OXA-48 and NDM are amongst the most prevalent carbapenemase types associated with Klebsiella pneumoniae worldwide, with an increase in their prevalence in recent years. Knowledge on the treatment of carbapenem-resistant Klebsiella pneumoniae (CRKP) comes from KPC-producing CRKP with limited data available for OXA-48-like and NDM producers. Our aim is to review the literature on the treatment of OXA-48-like and NDM-producing CRKP with the goal of providing an update on the available antibiotic treatment strategies, particularly in light of changing carbapenemase epidemiology and increasing antimicrobial resistance. Areas covered We reviewed studies looking at the antibiotic treatment and outcome of OXA-48-like and/or NDM-producing CRKP. Expert opinion The best available treatment option for OXA-48 producers is ceftazidime-avibactam, where available and when the price permits its use. Colistin remains as the second-line option if in vitro susceptibility is demonstrated with an appropriate method. There is not enough evidence to support the use of meropenem-containing combination therapies for meropenem-resistant OXA-48 producers. Treatment of NDM producers is an unmet need. Ceftazidime-avibactam and aztreonam combination or cefiderocol can be used for NDM producers, where available. Higher cefiderocol MICs against NDM producers is concerning. Aztreonam-avibactam provides hope for the treatment of NDM producers.