{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T17:37:13Z","timestamp":1787593033119,"version":"build-2736575974"},"reference-count":46,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Norberto Quirno Foundation scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Few studies have evaluated the efficacy of ceftazidime\u2013avibactam (CA) for Klebsiella pneumoniae carbapenemase-producing Enterobacterales bacteremia (KPC-PEB) in high-risk neutropenic patients. This is a prospective multicenter observational study in high-risk neutropenic patients with multi-drug resistant Enterobacterales bacteremia. They were compared according to the resistance mechanism and definitive treatment provided: KPC-CPE treated with CA (G1), KPC-CPE treated with other antibiotics (G2), and patients with ESBL-producing Enterobacterales bacteremia who received appropriate definitive therapy (G3). Thirty-day mortality was evaluated using a logistic regression model, and survival was analyzed with Kaplan\u2013Meier curves. A total of 238 patients were included: 18 (G1), 52 (G2), and 168 (G3). Klebsiella spp. (60.9%) and Escherichia coli (26.4%) were the Enterobacterales most frequently isolated, and 71% of the bacteremias had a clinical source. The resistance profile between G1 and G2 was colistin 35.3% vs. 36.5%, amikacin 16.7% vs. 40.4%, and tigeclycline 11.1% vs. 19.2%. The antibiotics prescribed in combination with G2 were carbapenems, colistin, amikacin, fosfomycin, tigecycline, and fluoroquinolones. Seven-day clinical response in G1 vs. G2 vs. G3 was 94.4% vs. 42.3% vs. 82.7%, respectively (p &lt; 0.001). Thirty-day overall mortality in G1 vs. G2 vs. G3 was 22.2% vs. 53.8% vs. 11.9%, respectively (p &lt; 0.001), and infection-related mortality was 5.5% vs. 51.9% vs. 7.7% (p &lt; 0.001). The independent risk factors for mortality were Pitt score &gt; 4: OR 3.63, 95% CI, 1.18\u201311.14 (p = 0.025) and KPC-PEB treated with other antibiotics: OR 8.85, 95% CI, 2.58\u201330.33 (p = 0.001), while 7-day clinical response was a protective factor for survival: OR 0.02, 95% CI, 0.01\u20130.08 (p &lt; 0.001). High-risk neutropenic patients with KPC-CPE treated with CA had an outcome similar to those treated for ESBL-producing Enterobacterales, with higher 7-day clinical response and lower overall and infection-related mortality than those treated with other antibiotics. In view of these data, CA may be considered the preferred therapeutic option for KPC-PEB in high-risk neutropenic patients.<\/jats:p>","DOI":"10.3390\/microorganisms12010195","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T06:41:22Z","timestamp":1705560082000},"page":"195","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Ceftazidime\u2013Avibactam Improves Outcomes in High-Risk Neutropenic Patients with Klebsiella pneumoniae Carbapenemase-Producing Enterobacterales Bacteremia"],"prefix":"10.3390","volume":"12","author":[{"given":"Fabi\u00e1n","family":"Herrera","sequence":"first","affiliation":[{"name":"Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas (CEMIC), Buenos Aires C1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3831-4561","authenticated-orcid":false,"given":"Diego","family":"Torres","sequence":"additional","affiliation":[{"name":"Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas (CEMIC), Buenos Aires C1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Laborde","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n para Combatir la Leucemia, Buenos Aires C1114, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosana","family":"Jord\u00e1n","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital Brit\u00e1nico de Buenos Aires, Buenos Aires C1280, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2413-662X","authenticated-orcid":false,"given":"Noelia","family":"Ma\u00f1ez","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires C1199, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Berruezo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital HIGA Rodolfo Rossi, La Plata B1902, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Lambert","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital El Cruce, Buenos Aires B1888, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Suchowiercha","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital HIGA Gral. San Mart\u00edn, La Plata B1900, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Costantini","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Instituto de Oncolog\u00eda Angel H. Roffo, Buenos Aires C1417, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Nenna","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital Municipal de Oncolog\u00eda Marie Curie, Buenos Aires C1405, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Laura","family":"Pereyra","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital Universitario Austral, Buenos Aires B1629, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Benso","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, Internal Medicine Department, Hospital Italiano de San Justo, Buenos Aires C1198, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Luz","family":"Gonz\u00e1lez Iba\u00f1ez","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n para Combatir la Leucemia, Buenos Aires C1114, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Eusebio","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital Brit\u00e1nico de Buenos Aires, Buenos Aires C1280, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Barc\u00e1n","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires C1199, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Baldoni","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital HIGA Rodolfo Rossi, La Plata B1902, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Tula","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital El Cruce, Buenos Aires B1888, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00e9s","family":"Roccia Rossi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital HIGA Gral. 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