Yıl: 2023 Cilt: 16 Sayı: 2 Sayfa Aralığı: 290 - 297 Metin Dili: İngilizce İndeks Tarihi: 19-04-2023

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

Öz:
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 (p=0.03). Similarly, Charlson’s comorbidity index (p=0.03) and the qSOFA values (p=0.00) were significantly higher in the patients who died. The microbiological response rate was higher in the patients who survived (p=0.01) with no difference in bacteremia between the groups (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 (p=0.00 and p=0.04, respectively). However, monotherapy and combination therapy in groups of patients without sepsis were insignificant (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.
Anahtar Kelime: Klebsiella pneumoniae carbapenem-resistant healthcare-associated infection; urinary tract infection

Karbapenem dirençli Klebsiella pneumonia’nın neden olduğu idrar yolu enfeksiyonları: monoterapi ya da kombineterapi?

Öz:
Amaç: Bu çalışmada karbapenem dirençli Klebsiella pneumoniae'nın neden olduğu sağlık hizmeti ilişkili üriner sistem enfeksiyonlarını değerlendirildi. Gereç yöntem: Çalışmaya karbapenem dirençli Klebsiella pneumoniae'nın (CR-Kp)neden olduğu sağlık hizmeti ilişkili idrar yolu enfeksiyonu tanısı almış 134 hasta dahil edildi. Hastaların demografik özellikleri, başlangıç klinik durumları, komorbiditeleri ve Charlson komorbidite indeksi kaydedildi. Ayrıca meropenemin CR-Kp izolatları üzerindeki MİK değerleri, tedavi rejimleri, tedaviye klinik ve mikrobiyolojik yanıtları ile hastaların 14 ve 28 günlük mortalite oranları incelendi. Bulgular: 14 günlük mortalite oranı %34,3, 28 günlük mortalite oranı ise %42,5 bulundu. Ölen hastaların yaş ortalaması anlamlı olarak daha yüksekti (p=0,03). Benzer şekilde ölen hastalarda Charlson komorbidite indeksi (p=0,03) ve qSOFA değerleri (p=0,00) anlamlı olarak yüksekti. Yaşayan hastalarda mikrobiyolojik yanıt oranı daha yüksekti (p=0,01) ve bakteriyemi açısından gruplar arasında fark yoktu (p=0,29). Sepsisli hasta grubunda kombine antibiyoterapinin 14 ve 28 günlük mortalite oranlarını monoterapiye göre anlamlı olarak daha üstün olduğu saptandı (sırasıyla p=0,00 ve p=0,04). Ancak sepsis olmayan hasta gruplarında monoterapi ve kombinasyon tedavisi arasında anlamlı fark yoktu (sırasıyla p=0,72 ve p=0,36). Sonuç: Çalışmamız, CR-Kp'nin neden olduğu üriner sistem enfeksiyonlarının tedavisinde sepsisli hastalarda kombinasyon tedavisinin, sepsis olmayan hastalarda ise in vitro aktif bir ajanla monoterapinin kullanılabileceğini desteklemektedir.
Anahtar Kelime: Klebsiella pneumonia karbapenem dirençli sağlık hizmetiyle ilişkili enfeksiyon idrar yolu enfeksiyonu.

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Temoçin F, Kayhan Ş, Şensoy L, Bayirli Turan D, atilla a, TANYEL E (2023). Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?. , 290 - 297.
Chicago Temoçin Fatih,Kayhan Şeyma Betül,Şensoy Levent,Bayirli Turan Derya,atilla aynur,TANYEL ESRA Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?. (2023): 290 - 297.
MLA Temoçin Fatih,Kayhan Şeyma Betül,Şensoy Levent,Bayirli Turan Derya,atilla aynur,TANYEL ESRA Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?. , 2023, ss.290 - 297.
AMA Temoçin F,Kayhan Ş,Şensoy L,Bayirli Turan D,atilla a,TANYEL E Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?. . 2023; 290 - 297.
Vancouver Temoçin F,Kayhan Ş,Şensoy L,Bayirli Turan D,atilla a,TANYEL E Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?. . 2023; 290 - 297.
IEEE Temoçin F,Kayhan Ş,Şensoy L,Bayirli Turan D,atilla a,TANYEL E "Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?." , ss.290 - 297, 2023.
ISNAD Temoçin, Fatih vd. "Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?". (2023), 290-297.
APA Temoçin F, Kayhan Ş, Şensoy L, Bayirli Turan D, atilla a, TANYEL E (2023). Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?. Pamukkale Tıp Dergisi, 16(2), 290 - 297.
Chicago Temoçin Fatih,Kayhan Şeyma Betül,Şensoy Levent,Bayirli Turan Derya,atilla aynur,TANYEL ESRA Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?. Pamukkale Tıp Dergisi 16, no.2 (2023): 290 - 297.
MLA Temoçin Fatih,Kayhan Şeyma Betül,Şensoy Levent,Bayirli Turan Derya,atilla aynur,TANYEL ESRA Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?. Pamukkale Tıp Dergisi, vol.16, no.2, 2023, ss.290 - 297.
AMA Temoçin F,Kayhan Ş,Şensoy L,Bayirli Turan D,atilla a,TANYEL E Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?. Pamukkale Tıp Dergisi. 2023; 16(2): 290 - 297.
Vancouver Temoçin F,Kayhan Ş,Şensoy L,Bayirli Turan D,atilla a,TANYEL E Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?. Pamukkale Tıp Dergisi. 2023; 16(2): 290 - 297.
IEEE Temoçin F,Kayhan Ş,Şensoy L,Bayirli Turan D,atilla a,TANYEL E "Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?." Pamukkale Tıp Dergisi, 16, ss.290 - 297, 2023.
ISNAD Temoçin, Fatih vd. "Urinary tract infections caused by carbapenem-resistant Klebsiella pneumonia: monotherapy or combined therapy?". Pamukkale Tıp Dergisi 16/2 (2023), 290-297.