{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:17:21Z","timestamp":1788387441147,"version":"build-2803163510"},"reference-count":56,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Ceftazidime-avibactam (CA) and CA plus aztreonam (ATM) are the preferred treatment options for KPC and MBL carbapenemase-producing Enterobacterales infections (CPEis). All episodes of monomicrobial CPEis in immunosuppressed patients (IPs) admitted from May 2019 to November 2024, who received definitive antibiotic therapy (AT) with CA or CA + ATM for at least 72 h, were prospectively included. Bacteremic episodes (BEs) and non-bacteremic episodes (NBEs) were compared. Logistic regressions adjusted by propensity score were used to identify variables associated with 30-day overall mortality. In total, 82 CPEis were included (38 NBEs and 44 BEs). BEs more frequently occurred in hematological malignancies (52.3% vs. 15.8%, p = 0.0006), while NBEs were more commonly observed in solid organ transplantation (73.7% vs. 34.1%, p = 0.001). K. pneumoniae was the main isolated microorganism; KPC-CPE was the most common resistance mechanism in both groups, followed by MBL-CPE. The 7-day clinical response, 30-day overall and infection-related mortality between NBEs and BEs were 92.1% vs. 88.6%, p = 0.59, 10.5% vs. 27.3%, p = 0.09, and 2.6% vs. 13.6%, p = 0.11. Septic shock, OR 6.5, 95% CI, 1.58\u201326.72 (p = 0.01), and refractory malignancy, OR 5.6, 95% CI, 1.03\u201330.14 (p = 0.046), were associated with 30-day mortality, whereas BEs were not, OR 1.5, 95% CI, 0.36\u20136.2 (p = 0.56). CPEis in both NBE and BE IPs who received definitive AT with CA or CA + ATM correlated with a high rate of 7-day clinical response and low 30-day infection-related mortality. Underlying malignancy and disease severity were associated with 30-day overall mortality. Regional knowledge of bacterial antibiotic resistance enables the implementation of individualized AT to improve patient survival.<\/jats:p>","DOI":"10.3390\/pathogens14121300","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:06:56Z","timestamp":1766052416000},"page":"1300","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ceftazidime-Avibactam Regimens for the Treatment of Bacteremic and Non-Bacteremic Episodes of Carbapenemase-Producing Enterobacterales Infections in Immunosuppressed Patients"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8900-4400","authenticated-orcid":false,"given":"Fabi\u00e1n","family":"Herrera","sequence":"first","affiliation":[{"name":"Infectious Diseases Section, Internal Medicine Department, 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":"Infectious Diseases Section, Internal Medicine Department, Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas, CEMIC, Buenos Aires C1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8039-2707","authenticated-orcid":false,"given":"Mar\u00eda","family":"Leone","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, Internal Medicine Department, Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas, CEMIC, Buenos Aires C1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0112-8455","authenticated-orcid":false,"given":"Maximiliano Gabriel","family":"Castro","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, Internal Medicine Department, Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas, CEMIC, Buenos Aires C1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge L\u00f3pez","family":"Camelo","sequence":"additional","affiliation":[{"name":"CEMIC-CONICET Research Unit, Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas, CEMIC, Buenos Aires C1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Temporiti","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, Internal Medicine Department, Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas, CEMIC, Buenos Aires C1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalin","family":"Grippo","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas, CEMIC, Buenos Aires C1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Relloso","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas, CEMIC, Buenos Aires C1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Bonveh\u00ed","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, Internal Medicine Department, Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas, CEMIC, Buenos Aires C1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"106679","DOI":"10.1016\/j.ijantimicag.2022.106679","article-title":"Geographic patterns of global isolates of carbapenem-resistant Klebsiella pneumoniae and the activity of ceftazidime\/avibactam, meropenem\/vaborbactam, and comparators against these isolates: Results from the Antimicrobial Testing Leadership and Surveillance (ATLAS) program, 2020","volume":"60","author":"Lee","year":"2022","journal-title":"Int. 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