Carbapenem-resistant organisms: Difference between revisions
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*For KPC, the most common Class A carbapenemase, consider: |
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**[[Ceftazidime-avibactam]] |
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**[[Meropenem-vaborbactam]] |
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**[[Imipenem-relebactam]] |
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**[[Cefiderocol]] |
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*For AmpCs, consider: |
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**[[Ceftazidime-avibactam]] |
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**[[Meropenem-vaborbactam]] |
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*For metallo-β-lactamases, consider: |
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**[[Aztreonam-avibactam]], or [[ceftazidime-avibactam]] plus [[aztreonam]] |
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**[[Cefiderocol]] |
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*For all of the above, also consider: |
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**[[Eravacycline]] |
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**[[Tigecycline]] |
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**[[Colistin]], though increasing resistance |
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**[[Plazomicin]] |
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*For carbapenem-resistant [[Pseudomonas aeruginosa]], consider: |
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**[[Cefiderocol]] |
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**[[Imipenem-relebactam]] |
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[[Category:Bacteria]] |
[[Category:Bacteria]] |
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Revision as of 12:16, 21 September 2020
Background
- Mechanisms include decreased expression of porins, increased expression of efflux pumps, and carbapenemases
Management
| Antibiotic | KPC | NDM | OXA-48 | CRPsA | CRAcB | Stenotrophomonas |
|---|---|---|---|---|---|---|
| aztreonam-avibactam | + | + | + | ± | – | + |
| cefiderocol | + | + | + | + | + | + |
| ceftazidime-avibactam | + | – | + | ± | – | – |
| ceftolozane-tazobactam | – | – | – | ± | – | ± |
| eravacycline | + | + | + | – | + | + |
| fosfomycin | ± | ± | ± | ± | – | – |
| imipenem-relebactam | + | – | ± | + | – | – |
| meropenem-vaborbactam | + | – | – | – | – | – |
| plazomicin | + | ± | + | ± | – | – |
| colistin | ± | ± | ± | ± | ± | ± |
| tigecycline | + | + | + | – | + | + |
- For KPC, the most common Class A carbapenemase, consider:
- For AmpCs, consider:
- For metallo-β-lactamases, consider:
- For all of the above, also consider:
- Eravacycline
- Tigecycline
- Colistin, though increasing resistance
- Plazomicin
- For carbapenem-resistant Pseudomonas aeruginosa, consider:
References
- ^ Mical Paul, Elena Carrara, Pilar Retamar, Thomas Tängdén, Roni Bitterman, Robert A. Bonomo, Jan de Waele, George L. Daikos, Murat Akova, Stephan Harbarth, Celine Pulcini, José Garnacho-Montero, Katja Seme, Mario Tumbarello, Paul Christoffer Lindemann, Sumanth Gandra, Yunsong Yu, Matteo Bassetti, Johan W. Mouton, Evelina Tacconelli, Jesús Rodríguez-Baño. European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines for the treatment of infections caused by multidrug-resistant Gram-negative bacilli (endorsed by European society of intensive care medicine). Clinical Microbiology and Infection. 2022;28(4):521-547. doi:10.1016/j.cmi.2021.11.025.
