Real-world, Multicenter Experience with Meropenem-Vaborbactam for Gram-Negative Bacterial Infections including Carbapenem-Resistant Enterobacterales and Pseudomonas aeruginosa

Sara Alosaimy, Abdalhamid M. Lagnf, Taylor Morrisette, Marco R. Scipione, Jing J. Zhao, Sarah C.J. Jorgensen, Ryan Mynatt, Travis J. Carlson, Jinhee Jo, Kevin W. Garey, David Allen, Kailynn Deronde, Ana D. Vega, Lilian M. Abbo, Veena Venugopalan, Vasilios Athans, Stephen Saw, Kimberly C. Claeys, Mathew Miller, Kyle C. MolinaMichael Veve, Wesley D. Kufel, Lee Amaya, Christine Yost, Jessica Ortwine, Susan L. Davis, Michael J. Rybak

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: We aimed to describe the clinical characteristics and outcomes of patients treated with meropenem-vaborbactam (MEV) for a variety of gram-negative infections (GNIs), primarily including carbapenem-resistant Enterobacterales (CRE). Methods: This is a real-world, multicenter, retrospective cohort within the United States between 2017 and 2020. Adult patients who received MEV for ≥72 hours were eligible for inclusion. The primary outcome was 30-day mortality. Classification and regression tree analysis (CART) was used to identify the time breakpoint (BP) that delineated the risk of negative clinical outcomes (NCOs) and was examined by multivariable logistic regression analysis (MLR). Results: Overall, 126 patients were evaluated from 13 medical centers in 10 states. The most common infection sources were respiratory tract (38.1%) and intra-abdominal (19.0%) origin, while the most common isolated pathogens were CRE (78.6%). Thirty-day mortality and recurrence occurred in 18.3% and 11.9%, respectively. Adverse events occurred in 4 patients: Nephrotoxicity (n = 2), hepatoxicity (n = 1), and rash (n = 1). CART-BP between early and delayed treatment was 48 hours (P =. 04). MEV initiation within 48 hours was independently associated with reduced NCO following analysis by MLR (adusted odds ratio, 0.277; 95% CI, 0.081-0.941). Conclusions: Our results support current evidence establishing positive clinical and safety outcomes of MEV in GNIs, including CRE. We suggest that delaying appropriate therapy for CRE significantly increases the risk of NCOs.

Original languageEnglish (US)
Article numberofab371
JournalOpen Forum Infectious Diseases
Volume8
Issue number8
DOIs
StatePublished - Aug 1 2021

Keywords

  • carbapenem-resistant Enterobacterales
  • gram-negative infections
  • meropenem-vaborbactam
  • multidrug-resistant

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Real-world, Multicenter Experience with Meropenem-Vaborbactam for Gram-Negative Bacterial Infections including Carbapenem-Resistant Enterobacterales and Pseudomonas aeruginosa'. Together they form a unique fingerprint.

Cite this