Outcomes and Predictors of Mortality in Patients With KPC-Kp Infections Treated With Meropenem Vaborbactam: An Observational Multicenter Study

Tumbarello, Mario; 2, 1; Raffaelli, Francesca; 3 Maddalena Giannella,; 4 Gennaro De Pascale,; 5,; 6 Antonio Cascio,; 7,; 8 Francesco Giuseppe De Rosa,; 9,; Cattelan, Annamaria; 10,; 11 Alessandra Oliva,; 12,; Saracino, Annalisa; 13 Matteo Bassetti,; 14,; 15 Cristina Mussini,; 16 Roberto Luzzati,; 17 Alessandro Capone,; 18 Liana Signorini,; 19 Michele Bartoletti,; 20,; 21 Margherita Sambo,; 1,; 2 Loredana Sarmati,; 22,; Antinori, Spinello; 23,; Mularoni, Alessandra; 24 Carlo Tascini,; 25 Alberto Corona,; 26 Renato Pascale,; 4 Raffaella Rubino,; 8 Silvia Corcione,; 9,; Mazzitelli, Maria; 10 Gabriele Giuliano,; 2 Antonio Lovecchio,; 17 Davide Fiore Bavaro,; 13 Marianna Meschiari,; 16,; Montagnani, Francesca; 1,; 2 Massimiliano Fabbiani,; 1,; 2 Ilaria De Benedetto,; 9 Massimo Antonelli,; 5,; 6 Mario Venditti,; 12 And Pierluigi Viale,

doi:10.1093/ofid/ofae273

Background: Meropenem-vaborbactam is a recent and promising option for the treatment of KPC-producing Klebsiella pneumoniae (KPC-Kp) infections, including those resistant to ceftazidime-avibactam. Methods: We conducted a retrospective analysis of observational data from 19 Italian hospitals on use and outcomes of patients treated with meropenem-vaborbactam for at least ≥24 hours for KPC-Kp infections. Crude and propensity-weighted multiple Cox regression models were performed to ascertain risk factors independently associated with 30-day mortality. Results: The cohort included 342 adults with bloodstream infections (n = 172) and nonbacteremic infections (n = 170), of which 107 were lower respiratory tract infections, 30 were complicated urinary tract infections, and 33 were infections involving other sites. Most infections (62.3%) were managed with meropenem-vaborbactam monotherapy, or in combination with at least 1 other active drug (usually fosfomycin, tigecycline, or gentamicin) (3...