Ceftazidime–Avibactam Resistance in Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infections: Risk Factors and Clinical Outcomes
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND/INTRODUCTION: Carbapenem-resistant Klebsiella pneumoniae (CRKP) bacteremia is a serious public health problem due to its high mortality rate and limited treatment options. This study aimed to identify risk factors associated with ceftazidime-avibactam (CAZ-AVI) resistance in CRKP bacteremia and to evaluate its impact on clinical outcomes. METHODS: This retrospective single-center cohort study included adult patients with CRKP bloodstream infections treated at a tertiary hospital in Türkiye between January 2021 and December 2024. Demographic, clinical, and laboratory data were collected, and risk factors for CAZ-AVI resistance and 30-day mortality were analyzed. RESULTS: Among 154 patients, 42.8% had CAZ-AVI-resistant strains. Resistant infections were associated with longer hospital stays and higher Charlson Comorbidity Index (CCI) scores. The resistance rate was lower in patients with intra-abdominal infections, while fluoroquinolone and fosfomycin use was more common in the resistant group. The overall 30-day mortality rate was 57%. Pitt bacteremia score and creatinine levels were identified as independent predictors of mortality. DISCUSSION: CAZ-AVI resistance in CRKP bacteremia appears to develop in patients with prolonged hospitalization and high comorbidity burden. These factors likely increase exposure to resistant microorganisms and antibiotic pressure, complicating treatment outcomes. CONCLUSIONS: CAZ-AVI resistance in CRKP bacteremia is associated with specific clinical risk profiles and contributes to high mortality. Identifying high-risk patients and optimizing antimicrobial stewardship are essential to improve prognosis.
Source: Antibiotics
Authors: Ayten Yanık, Ömer Karaşahin
Institution: Erzurum Regional Training and Research Hospital
Language: English
Subfield: Molecular Medicine
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $3,499
OpenAlex ID: W4415613256