Skip to content
Research Article Open access CC BY 4.0

Systematic Review of Carbapenem Resistant Gram-negative Infective Endocarditis, Treatment Options and Outcomes

Walczak A.

Asian Journal of Research in Infectious Diseases · pp. 152–164 · Published 28 Dec 2023

10.9734/ajrid/2023/v14i4318

Abstract

Background: Gram negative infective endocarditis is rare and usually associated with intravenous drug use or significant healthcare exposure and prosthetic cardiac valves or devices. Carbapenem resistance is a growing concern worldwide with limited drug options for these infections especially serious high inoculum infections such as endocarditis. Methods: A systematic review examining treatment options and outcomes was conducted with identification of 12 cases in the literature. Results: Pseudomonas aeruginosa was the most common organism with left sided valvular involvement being most common. 18 different antibiotic regimens were used with surgery occurring in 5 cases (42%). In hospital mortality was 33% which increased at 6 months post episode. Increased age (p= 0.056) and CCI (p=0.006) appeared to be associated with death. Microbiological cure was more common in patients who received combination therapy with 2 active agents (75% successful) and combination therapy including an active beta-lactam agent (100% successful) but these did not meet statistical significance. Conclusions: Recommendations for management of this rare condition based on this systematic review and other available evidence are summarised in this review. Management should generally involve multidisciplinary teams, combination therapy with at least 2 active agents including a beta-lactam agent where possible with consideration of surgery in all cases. Evidence is however limited with need for ongoing publication of cases and further research to guide therapy in the future.

Carbapenem resistant gram negative infective endocarditis treatment outcome

References (28)

  1. 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement [DOI]
  2. 2 GRADE: an emerging consensus on rating quality of evidence and strength of recommendations [DOI]
  3. 3 ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions [DOI]
  4. 4 Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement [DOI]
  5. 5 Proposed Modifications to the Duke Criteria for the Diagnosis of Infective Endocarditis [DOI]
  6. 6 Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) [DOI]
  7. 7 Colistin: The Revival of Polymyxins for the Management of Multidrug-Resistant Gram-Negative Bacterial Infections [DOI]
  8. 8 Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis Executive Summary [DOI]
  9. 9 Cefiderocol: A Siderophore Cephalosporin with Activity Against Carbapenem-Resistant and Multidrug-Resistant Gram-Negative Bacilli [DOI]
  10. 10 Ceftolozane-Tazobactam for the Treatment of Multidrug-Resistant Pseudomonas aeruginosa Infections: Clinical Effectiveness and Evolution of Resistance [DOI]
  11. 11 Carbapenem-resistant Enterobacteriaceae in the community: a scoping review [DOI]
  12. 12 The CARE Guidelines: Consensus-based Clinical Case Report Guideline Development [DOI]
  13. 13 The infective endocarditis team: recommendations from an international working group [DOI]
  14. 14 Role of newer and re-emerging older agents in the treatment of infections caused by carbapenem-resistant Enterobacteriaceae [DOI]
  15. 15 Cefiderocol: a novel siderophore cephalosporin [DOI]
  16. 16 Compassionate Use of Cefiderocol as Adjunctive Treatment of Native Aortic Valve Endocarditis Due to Extremely Drug-resistant Pseudomonas aeruginosa [DOI]
  17. 17 Colistin: The Revival of Polymyxins for the Management of Multidrug-Resistant Gram-Negative Bacterial Infections [DOI]
  18. 18 INFECTIOUS DISEASES IN CLINICAL PRACTICE [DOI]
  19. 19 Ceftolozane–tazobactam: A new-generation cephalosporin [DOI]
  20. 20 Endocarditis due to gram-negative bacilli at a French teaching hospital over a 6-year period: clinical characteristics and outcome [DOI]
  21. 21 Multidrug Resistant Pseudomonas aeruginosa Causing Prosthetic Valve Endocarditis: A Genetic-Based Chronicle of Evolving Antibiotic Resistance [DOI]
  22. 22 Infective endocarditis due to multidrug resistant gram-negative bacilli: Single centre experience over 5years [DOI]
  23. 23 A challenging case of carbapenemase-producing Klebsiella pneumoniae septic thrombophlebitis and right mural endocarditis successfully treated with ceftazidime/avibactam [DOI]
  24. 24 Carbapenem-resistant Klebsiella pneumoniae endocarditis in a young adult [DOI]
  25. 25 Efficacy of tigecycline–colistin combination in the treatment of carbapenem-resistant Klebsiella pneumoniae endocarditis [DOI]
  26. 26 Relapsing tricuspid valve endocarditis by multidrug-resistant Pseudomonas aeruginosa in 11 years: tricuspid valve replacement with an aortic valve homograft [DOI]
  27. 27 Community-acquired multidrug-resistant Gram-negative bacterial infective endocarditis [DOI]
  28. 28 173. Successful Treatment of Carbapenem-Resistant Klebsiella pneumoniae (CR-Kp) Aortic Valve Endocarditis with Ceftazidime–Avibactam [DOI]

Cited by 0

No indexed citations yet.

Related research

Article metrics

Real usage data collected on this platform.

31

Page views

0

PDF downloads

14

Outbound clicks

0

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.