Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?

Authors : Fatih TEMOÇİN, Şeyma Betül KAYHAN, Levent ŞENSOY, Tuba KURUOĞLU, Aynur ATİLLA, Esra TANYEL

Pages : 290-297

Doi:10.31362/patd.1244480

View : 23 | Download : 12

Publication Date : 2023-04-05

Article Type : Research Paper

Abstract :Purpose: In this study, we evaluated healthcare-associated urinary tract infections caused by carbapenem-resistant Klebsiella pneumoniae. Materials and methods: The study included 134 patients, diagnosed with healthcare-associated urinary tract infection caused by carbapenem-resistant Klebsiella pneumoniae. Demographic features, initial clinical conditions, comorbidities, and Charlson’s comorbidity index of the patients were recorded. In addition, the MIC values of meropenem on the CR-Kp isolates, treatment regimens, clinical and microbiological responses to the treatment, as well as 14- and 28-day mortality rates of the patients, were reviewed. Results: The 14-day mortality rate was 34.3%, and the 28-day mortality rate was 42.5%. The mean age of the patients who died was significantly higher insert ignore into journalissuearticles values(p=0.03);. Similarly, Charlson’s comorbidity index insert ignore into journalissuearticles values(p=0.03); and the qSOFA values insert ignore into journalissuearticles values(p=0.00); were significantly higher in the patients who died. The microbiological response rate was higher in the patients who survived insert ignore into journalissuearticles values(p=0.01); with no difference in bacteremia between the groups insert ignore into journalissuearticles values(p=0.29);. It was found that combined antibiotherapy provided significantly better 14- and 28-day mortality rates compared to monotherapy in the group of patients with sepsis insert ignore into journalissuearticles values(p=0.00 and p=0.04, respectively);. However, monotherapy and combination therapy in groups of patients without sepsis were insignificant insert ignore into journalissuearticles values(p=0.72 and p=0.36, respectively);. Conclusion: Our study supports the use of combination therapy in patients with sepsis, and monotherapy with an in-vitro active agent may be used for patients without sepsis in the treatment of urinary tract infections caused by CR-KP.
Keywords : Klebsiella pneumonia, karbapenem dirençli, sağlık hizmetiyle ilişkili enfeksiyon, idrar yolu enfeksiyonu