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Real-life temocillin use in Greater Paris area, effectiveness and risk factors for failure in infections caused by ESBL-producing Enterobacterales: a multicentre retrospective study

BACKGROUND: Temocillin is a β-lactam that is not hydrolysed by ESBLs OBJECTIVES: To describe the real-life use of temocillin, to assess its effectiveness in infections caused by ESBL-producing Enterobacterales, and to identify risk factors for treatment failure. METHODS: Retrospective multicentric s...

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Autores principales: Dinh, Aurélien, Duran, Clara, Singh, Simrandeep, Tesmoingt, Chloé, Bouabdallah, Laura, Hamon, Antoine, Antignac, Marie, Ourghanlian, Clément, Loustalot, Marie-Caroline, Pain, Jean Baptiste, Wyplosz, Benjamin, Junot, Helga, Bleibtreu, Alexandre, Michelon, Hugues
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9798080/
https://www.ncbi.nlm.nih.gov/pubmed/36601547
http://dx.doi.org/10.1093/jacamr/dlac132
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author Dinh, Aurélien
Duran, Clara
Singh, Simrandeep
Tesmoingt, Chloé
Bouabdallah, Laura
Hamon, Antoine
Antignac, Marie
Ourghanlian, Clément
Loustalot, Marie-Caroline
Pain, Jean Baptiste
Wyplosz, Benjamin
Junot, Helga
Bleibtreu, Alexandre
Michelon, Hugues
author_facet Dinh, Aurélien
Duran, Clara
Singh, Simrandeep
Tesmoingt, Chloé
Bouabdallah, Laura
Hamon, Antoine
Antignac, Marie
Ourghanlian, Clément
Loustalot, Marie-Caroline
Pain, Jean Baptiste
Wyplosz, Benjamin
Junot, Helga
Bleibtreu, Alexandre
Michelon, Hugues
author_sort Dinh, Aurélien
collection PubMed
description BACKGROUND: Temocillin is a β-lactam that is not hydrolysed by ESBLs OBJECTIVES: To describe the real-life use of temocillin, to assess its effectiveness in infections caused by ESBL-producing Enterobacterales, and to identify risk factors for treatment failure. METHODS: Retrospective multicentric study in eight tertiary care hospitals in the Greater Paris area, including patients who received at least one dose of temocillin for ESBL infections from 1 January to 31 December 2018. 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. A logistic regression with univariable and multivariable analysis was performed to identify risks associated with failure. RESULTS: Data on 130 infection episodes were collected; 113 were due to ESBL-producing Enterobacterales. Mean age was 65.2 ± 15.7 years and 68.1% patients were male. Indications were mostly urinary tract infections (UTIs) (85.8%), bloodstream infections (11.5%), respiratory tract infections (RTIs) (3.5%) and intra-abdominal infections (3.5%). Bacteria involved were Escherichia coli (49.6%), Klebsiella pneumoniae (44.2%) and Enterobacter cloacae (8.8%). Polymicrobial infections occurred in 23.0% of cases. Temocillin was mostly used in monotherapy (102/113, 90.3%). Failure was found in 13.3% of cases. Risk factors for failure in multivariable analysis were: RTI (aOR 23.3, 95% CI 1.5–358.2) and neurological disease (aOR 5.3, 95% CI 1.5–18.6). CONCLUSIONS: The main use of temocillin was UTI due to ESBL-producing E. coli and K. pneumoniae, with a favourable clinical outcome. The main risk factor for failure was neurological disease.
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spelling pubmed-97980802023-01-03 Real-life temocillin use in Greater Paris area, effectiveness and risk factors for failure in infections caused by ESBL-producing Enterobacterales: a multicentre retrospective study Dinh, Aurélien Duran, Clara Singh, Simrandeep Tesmoingt, Chloé Bouabdallah, Laura Hamon, Antoine Antignac, Marie Ourghanlian, Clément Loustalot, Marie-Caroline Pain, Jean Baptiste Wyplosz, Benjamin Junot, Helga Bleibtreu, Alexandre Michelon, Hugues JAC Antimicrob Resist Original Article BACKGROUND: Temocillin is a β-lactam that is not hydrolysed by ESBLs OBJECTIVES: To describe the real-life use of temocillin, to assess its effectiveness in infections caused by ESBL-producing Enterobacterales, and to identify risk factors for treatment failure. METHODS: Retrospective multicentric study in eight tertiary care hospitals in the Greater Paris area, including patients who received at least one dose of temocillin for ESBL infections from 1 January to 31 December 2018. 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. A logistic regression with univariable and multivariable analysis was performed to identify risks associated with failure. RESULTS: Data on 130 infection episodes were collected; 113 were due to ESBL-producing Enterobacterales. Mean age was 65.2 ± 15.7 years and 68.1% patients were male. Indications were mostly urinary tract infections (UTIs) (85.8%), bloodstream infections (11.5%), respiratory tract infections (RTIs) (3.5%) and intra-abdominal infections (3.5%). Bacteria involved were Escherichia coli (49.6%), Klebsiella pneumoniae (44.2%) and Enterobacter cloacae (8.8%). Polymicrobial infections occurred in 23.0% of cases. Temocillin was mostly used in monotherapy (102/113, 90.3%). Failure was found in 13.3% of cases. Risk factors for failure in multivariable analysis were: RTI (aOR 23.3, 95% CI 1.5–358.2) and neurological disease (aOR 5.3, 95% CI 1.5–18.6). CONCLUSIONS: The main use of temocillin was UTI due to ESBL-producing E. coli and K. pneumoniae, with a favourable clinical outcome. The main risk factor for failure was neurological disease. Oxford University Press 2022-12-29 /pmc/articles/PMC9798080/ /pubmed/36601547 http://dx.doi.org/10.1093/jacamr/dlac132 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Dinh, Aurélien
Duran, Clara
Singh, Simrandeep
Tesmoingt, Chloé
Bouabdallah, Laura
Hamon, Antoine
Antignac, Marie
Ourghanlian, Clément
Loustalot, Marie-Caroline
Pain, Jean Baptiste
Wyplosz, Benjamin
Junot, Helga
Bleibtreu, Alexandre
Michelon, Hugues
Real-life temocillin use in Greater Paris area, effectiveness and risk factors for failure in infections caused by ESBL-producing Enterobacterales: a multicentre retrospective study
title Real-life temocillin use in Greater Paris area, effectiveness and risk factors for failure in infections caused by ESBL-producing Enterobacterales: a multicentre retrospective study
title_full Real-life temocillin use in Greater Paris area, effectiveness and risk factors for failure in infections caused by ESBL-producing Enterobacterales: a multicentre retrospective study
title_fullStr Real-life temocillin use in Greater Paris area, effectiveness and risk factors for failure in infections caused by ESBL-producing Enterobacterales: a multicentre retrospective study
title_full_unstemmed Real-life temocillin use in Greater Paris area, effectiveness and risk factors for failure in infections caused by ESBL-producing Enterobacterales: a multicentre retrospective study
title_short Real-life temocillin use in Greater Paris area, effectiveness and risk factors for failure in infections caused by ESBL-producing Enterobacterales: a multicentre retrospective study
title_sort real-life temocillin use in greater paris area, effectiveness and risk factors for failure in infections caused by esbl-producing enterobacterales: a multicentre retrospective study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9798080/
https://www.ncbi.nlm.nih.gov/pubmed/36601547
http://dx.doi.org/10.1093/jacamr/dlac132
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