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Questions and Answers
What type of resistance do Klebsiella pneumoniae and OXA show?
What is the primary concern in treating CRAB infections in ICU patients?
What is the mortality rate for invasive forms of CRAB infections?
What is the significance of the fifth day of hospital stay?
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What is the outcome of the patient who received monotherapy with sulbactam for CRAB infection?
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What is the purpose of prophylactic and follow-up measures in CRAB infections?
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What is the significance of levofloxacin in the treatment of CRAB infections?
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What is the finding of a recent study from Spain regarding MDR AB?
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What is the prevalence of Acinetobacter bacteremia in some intensive care units?
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What was the most common etiological agent in a series of 250 patients with nosocomial ventilator-associated pneumonia?
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What was the isolation rate of multidrug-resistant Acinetobacter baumannii (MDR AB) in a series of 50 patients?
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Why was sulbactam, a beta-lactamase inhibitor, developed?
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What was the outcome when cefoperazone-sulbactam combination was used to treat CRAB-III?
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Why is sulbactam ampicillin combination not as effective as sulbactam cefoperazone?
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What is the advantage of sulbactam combinations over other therapies?
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How does the efficacy of sulbactam vary in different geographical communities?
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What is the role of sulbactam in combination therapy?
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What was the significance of the introduction of sulbactam?
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What was the overall survival rate of patients with carbapenem-resistant Acinetobacter baumannii (CRAB) treated with sulbactam?
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What was the mortality rate of patients with CRAB infections in the study?
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What was the significant predictor of unfavorable death outcomes in patients with CRAB infections?
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What was the mortality rate of patients with bloodstream infections (BSI) in the study?
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What was the treatment regimen for patients with CRAB infections in the sulbactam imipenem combination group?
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What was the significant factor associated with higher mortality in patients with CRAB infections?
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What was the percentage of patients with CRAB infections who had prior imipenem exposure?
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What was the percentage of patients who survived and were more than 50 years of age?
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What was the treatment regimen for patients with CRAB infections in the high-dose sulbactam group?
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What was the percentage of patients with CRAB infections who had carbapenem with aminoglycoside combination exposure?
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Study Notes
Multidrug-Resistant Bacteria
- The rise of multidrug-resistant bacteria in medical wards worldwide highlights the level of resistance to various antibiotics, including penicillins, aminopenicillins, and cephalosporins.
- These resistant bacteria are known to have resistance to Klebsiella pneumoniae carbapenemase (KPC) and OXA resistances.
Levofloxacin and In Vitro Inhibitory Effect
- Levofloxacin has shown clinical success in treatment plans, with easy drug compliance and clearance.
- However, the present case highlights the fatal outcome of infection due to an antibiotic showing no in vitro inhibitory effect on CRAB.
CRAB Infections and Mortality Rate
- CRAB causes a type of pneumonia that is difficult to treat in ICU patients, especially those on mechanical ventilation.
- The mortality rate varies widely, with higher rates (over 60%) in invasive forms of infections and lower rates (under 14%) in cultures from surveillance samples.
- Poorly chosen antibiotics can contribute to higher mortality rates.
Sulbactam Antibiotic
- Sulbactam is a β-lactamase inhibitor that has been used to treat CRAB infections.
- Despite its benefits, the mortality rate in patients under sulbactam regimen is equal to that of carbapenem-resistant Acinetobacter in hospital patients.
- Sulbactam cefoperazone combination seems to be more effective than sulbactam ampicillin combination.
Mortality Rates in CRAB Infections
- Overall mortality rate in CRAB infections is 24.8% (range 8% to 63%).
- Mortality rates vary depending on the site of infection: UTI (4.5%), BSI (58.7%), and wound infections (35.7%).
- High-dose sulbactam group had significantly better renal status than the non-survival group.
Risk Factors for Mortality
- BSI and immunocompromised status are associated with higher mortality rates.
- Age is also a significant factor, with mortality increasing in patients over 49 years old.
- Prior exposure to certain antibiotics, such as imipenem, carbapenem, and colistin, did not affect mortality rates.
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Description
This quiz covers the rising number of multidrug-resistant bacteria and their resistance to various antibiotics, as well as successful treatment plans. Topics include Klebsiella pneumoniae carbapenemase and OXA resistances, and the use of levofloxacin.
