Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals - Université de Lorraine Access content directly
Journal Articles Clinical Microbiology and Infection Year : 2018

Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals

L. Papst (1) , B. Beović (1) , C. Pulcini (2) , E. Durante-Mangoni (3) , J. Rodríguez-Baño (4) , K.S. Kaye (5) , G.L. Daikos (6) , L. Raka (7) , M. Paul (8) , L. Abbo (9) , P. Abgueguen (10) , B. Almirante (11) , A.M. Azzini (12) , F. Bani-Sadr (13) , M. Bassetti (14) , R. Ben-Ami (15) , G. Béraud (16) , E. Botelho-Nevers (17) , G. Bou (18) , D. Boutoille (19) , A. Cabié (20) , B. Cacopardo (21) , A. Cascio (22) , N. Cassir (23) , F. Castelli (24) , M. Cecala (25) , A. Charmillon (26) , C. Chirouze (27) , J.M. Cisneros (28) , J.D. Colmenero (29) , N. Coppola (30) , S. Corcione (31) , D. Dalla Gasperina (32) , C. de La Calle Cabrera (33) , Pierre Delobel (34) , D. Di Caprio (35) , E. Durante Mangoni (36) , M. Dupon (37) , N. Ettahar (38) , M.E. Falagas (39) , M. Falcone (40) , M.C. Fariñas (41) , Emmanuel Faure (42) , E. Forestier (43) , G. Fóti (44) , J. Gallagher (45) , G. Gattuso (46) , V. Gendrin (47) , I. Gentile (48) , D.R. Giacobbe (49) , C.A. Gogos (50) , L. Grandiere Perez (51) , Y. Hansmann (52) , J.P. Horcajada (53) , C. Iacobello (54) , J.T. Jacob (55) , J.A. Justo (56) , S. Kernéis (57) , A. Komnos (58) , B. Kotnik Kevorkijan (59) , D. Lebeaux (60) , R. Le Berre (61) , C. Lechiche (62) , V. Le Moxing (63) , F.X. Lescure (64) , M. Libanore (65) , M. Martinot (66) , E. Merino de Lucas (67) , V. Mondain (68) , P. Mondello (69) , M. Montejo (70) , J. Mootien (71) , P. Muñoz (72) , R. Nir-Paz (73) , A. Pan (74) , J.R. Paño-Pardo (75) , G. Patel (76) , M.T. Pérez Rodríguez (77) , L. Piroth (78) , J. Pogue (79) , B.A. Potoski (80) , V. Pourcher (81) , A. Pyrpasopoulou (82) , G. Rahav (83) , M. Rizzi (84) , M. Salavert (85) , M. Scheetz (86) , M. Sims (87) , G. Spahija (88) , S. Stefani (89) , A. Stefos (90) , P.D. Tamma (91) , P. Tattevin (92) , A. Tedesco (93) , J. Torre-Cisneros (94) , P. Tripolitsioti (95) , S. Tsiodras (96) , G. Uomo (97) , R. Verdon (98) , P. Viale (99) , V. Vitrat (100) , M. Weinberger (101) , Y. Wiener-Well (102)
1 UMCL - University Medical Centre Ljubljana [Ljubljana, Slovenia]
2 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
3 Monaldi Hospital
4 Hospital Virgen Macarena
5 University of Michigan Medical School [Ann Arbor]
6 NKUA - National and Kapodistrian University of Athens
7 University Clinical Center of Kosova
8 Rambam Health Care Campus
9 Jackson Memorial Hospital
10 CHU Angers - Centre Hospitalier Universitaire d'Angers
11 Vall d'Hebron University Hospital [Barcelona]
12 UNIVR - Università degli studi di Verona = University of Verona
13 CHU Reims - Hôpital universitaire Robert Debré [Reims]
14 Ospedale "Santa Maria della Misericordia" = University Hospital "Santa Maria della Misericordia"
15 Tel Aviv Sourasky Medical Centre
16 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
17 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
18 Hospital Universitario, A Coruña
19 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
20 CHU de la Martinique [Fort de France]
21 ARNAS “Garibaldi, S. Luigi-Currò, Ascoli-Tomaselli”
22 Università degli studi di Palermo - University of Palermo
23 APHM - Assistance Publique - Hôpitaux de Marseille
24 ASST Spedali Civili of Brescia,
25 ARNAS Civico Palermo
26 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
27 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
28 Hospital Universitario Virgen del Rocío [Sevilla]
29 Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain]
30 Università degli studi della Campania "Luigi Vanvitelli" = University of the Study of Campania Luigi Vanvitelli
31 UNITO - Università degli studi di Torino = University of Turin
32 Uninsubria - Universitá degli Studi dell’Insubria = University of Insubria [Varese]
33 Hospital Clínic de Barcelona
34 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
35 AO San Sebastiano
36 Monaldi Hospital
37 CHU Bordeaux
38 Centre hospitalier [Valenciennes, Nord]
39 Henry Dunant Hospital
40 UNIROMA - Università degli Studi di Roma "La Sapienza" = Sapienza University [Rome]
41 Hospital Marques de Valdecillas
42 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
43 Centre Hospitalier Métropole Savoie [Chambéry]
44 Ospedale di Reggio Calabria
45 CHOP - Children’s Hospital of Philadelphia
46 ASST Mantova - Carlo Poma Hospital Mantova
47 CH Belfort-Montbéliard
48 University of Naples Federico II = Università degli studi di Napoli Federico II
49 AUO San Martino IST Ist Nazl Ric Canc, I-16132 Genoa, Italy
50 University of Patras
51 Centre Hospitalier Le Mans (CH Le Mans)
52 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
53 IMIM-Hospital del Mar
54 Cannizzaro Hospital
55 Emory University School of Medicine
56 University of South Carolina [Columbia]
57 AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
58 General Hospital of Larissa
59 UKC Maribor - University medical centre Maribor
60 HEGP - Hôpital Européen Georges Pompidou [APHP]
61 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
62 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
63 CHU Montpellier
64 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
65 UniFE - Università degli Studi di Ferrara = University of Ferrara
66 CH Colmar
67 Hospital General Universitario de Alicante
68 CHU Nice [Cimiez]
69 AOU Policlinico "G. Martino", Messina, Italy
70 Hospital Universitario Cruces = Cruces University Hospital
71 CH E.Muller Mulhouse - Centre Hospitalier Emile Muller [Mulhouse]
72 Hospital General Universitario "Gregorio Marañón" [Madrid]
73 Hadassah Hebrew University Medical Center [Jerusalem]
74 Azienda Istituti Ospitalieri di Cremona
75 Lozano Blesa Clinical Hospital [Zaragoza, Spain]
76 MSH - Mount Sinai Hospital [Toronto, Canada]
77 Complejo Hospitalario de Vigo
78 CHU Dijon
79 Detroit Medical Center
80 UPMC - University of Pittsburgh Medical Center [Pittsburgh, PA, États-Unis]
81 CHU Pitié-Salpêtrière [AP-HP]
82 Hippokration General Hospital
83 Sheba Medical Centre, Ramat Gan, Israel
84 ASST Papa Giovanni XXIII [Bergamo, Italy]
85 Hospital Universitari i Politècnic La Fe = University and Polytechnic Hospital La Fe
86 Northwestern Hospital Chicago
87 Beaumont Hospital
88 Lagjia e Universitetit, Rruga 1, nr.32, 10000 Prishtina, Kosovo
89 Unict - Università degli studi di Catania = University of Catania
90 Larissa University Hospital
91 Johns Hopkins University School of Medicine [Baltimore]
92 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
93 Ospedale Fracastoro San Bonifacio [Verona]
94 Hospital Reina Sofia, Cordoba
95 Agioi Anargiroi Hospital
96 “Attikon” University Hospital
97 Ospedale Cardarelli
98 CHU Caen
99 UNIBO - Alma Mater Studiorum Università di Bologna = University of Bologna
100 CH Annecy Genevois
101 Assah Harofeh Medical Centre, Zerifin, Israel
102 Shaare Zedek Medical Centre, Jerusalem, Israel
L. Abbo
  • Function : Contributor
G. Bou
  • Function : Contributor
M. Cecala
  • Function : Contributor
D. Di Caprio
  • Function : Contributor
E. Durante Mangoni
  • Function : Contributor
M. Dupon
  • Function : Contributor
M.E. Falagas
  • Function : Contributor
G. Fóti
  • Function : Contributor
G. Gattuso
  • Function : Contributor
V. Gendrin
  • Function : Contributor
C.A. Gogos
  • Function : Contributor
J.P. Horcajada
  • Function : Contributor
C. Iacobello
  • Function : Contributor
A. Komnos
  • Function : Contributor
V. Le Moxing
  • Function : Contributor
M. Martinot
  • Function : Contributor
V. Mondain
  • Function : Contributor
L. Piroth
  • Function : Contributor
J. Pogue
  • Function : Contributor
M. Scheetz
  • Function : Contributor
M. Sims
  • Function : Contributor
A. Stefos
  • Function : Contributor
G. Uomo
  • Function : Contributor
R. Verdon
  • Function : Contributor
V. Vitrat
  • Function : Contributor

Abstract

Objectives: To explore contemporary antibiotic management of infections caused by carbapenem-resistant Gram-negative bacteria in hospitals. Methods: Cross-sectional, internet-based questionnaire survey. We contacted representatives of all hospitals with more than 800 acute-care hospital beds in France, Greece, Israel, Italy, Kosovo, Slovenia, Spain and selected hospitals in the USA. We asked respondents to describe the most common actual practice at their hospital regarding management of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa through close-ended questions. Results: Between January and June 2017, 115 of 141 eligible hospitals participated (overall response rate 81.6%, country-specific rates 66.7%-100%). Most were tertiary-care (99/114, 86.8%), university-affiliated (110/115, 89.1%) hospitals and most representatives were infectious disease specialists (99/115, 86.1%). Combination therapy was prescribed in 114/115 (99.1%) hospitals at least occasionally. Respondents were more likely to consider combination therapy when treating bacteraemia, pneumonia and central nervous system infections and for Enterobacteriaceae, P. aeruginosa and A. baumannii similarly. Combination of a polymyxin with a carbapenem was used in most cases, whereas combinations of a polymyxin with tigecycline, an aminoglycoside, fosfomycin or rifampicin were also common. Monotherapy was used for treatment of complicated urinary tract infections, usually with an aminoglycoside or a polymyxin. The intended goal of combination therapy was to improve the effectiveness of the treatment and to prevent development of resistance. In general, respondents shared the misconception that combination therapy is supported by strong scientific evidence. Conclusions: Combination therapy was the preferred treatment strategy for infections caused by carbapenem-resistant Gram-negative bacteria among hospital representatives, even though high-quality evidence for carbapenem-based combination therapy is lacking.

Dates and versions

hal-02373533 , version 1 (21-11-2019)

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L. Papst, B. Beović, C. Pulcini, E. Durante-Mangoni, J. Rodríguez-Baño, et al.. Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals. Clinical Microbiology and Infection, 2018, 24 (10), pp.1070-1076. ⟨10.1016/j.cmi.2018.01.015⟩. ⟨hal-02373533⟩
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