Diagnosis and Treatment of Carbapenemase-Producing Organisms —an Update

AbstractPurpose of reviewCarbapenem-producing organisms (CPO) have become important clinical pathogens in nosocomial infections causing increases in hospital stay, mortality, and costs. We sought to summarize recent findings related to the commonly encountered types of carbapenemases and their detection and review recent findings related to therapeutic options.Recent findingsMany new rapid and reliable methods of identifying carbapenem resistance have become available, underscoring the necessity to have the laboratory capacity for phenotypic and/or genotypic detection of carbapenemases to facilitate optimal therapy according to the characteristics of the isolate. The existing literature summaries on the use of combination therapy vs. monotherapy for CPO infections are based on predominantly observational studies and although they suggest a more favorable outcome in overall mortality with combination therapy, but there is significant heterogeneity within the studies, supporting the need for more randomized trials. Several novel therapeutic agents which hold promise for CPOs are in research and development stages and include zidebactam and nacubactam (β-lactamase inhibitors) in combination with cefepime and cefiderocol. In addition, clinical trials are either complete or ongoing with ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, aztreonam-avibactam, plazomicin, and eravacycline which offer promise for the future.SummaryThe management of CPO infections requ...
Source: Current Treatment Options in Infectious Diseases - Category: Infectious Diseases Source Type: research