Table 5.
Treatment outcome [n (%)] of all bloodstream infection (BSI) cases due to Enterobacter cloacae (Ecl) isolates: overall data and comparison between cases due to inducible (Ind-Ecl) and derepressed (Der-Ecl) isolates.
| Antimicrobial administered | Phenotype and BSI casesa,b,c | All BSIs due to E. cloacae (n = 51)d | BSIs due to Ind-Ecl (n = 31) | BSIs due to Der-Ecl (n = 15)c | |||
|---|---|---|---|---|---|---|---|
| Responders | Non-responders | Responders | Non-responders | Responders | Non-responders | ||
| CRO | Ind-Ecl: 11, 14, 21, 24, 30-I, p48 | 4 (57.1)e | 3 (42.9) | 4 (66.7) | 2 (33.3) | – | 1 (100) |
| Der-Ecl: 26-B | |||||||
| FEP | Ind-Ecl: 4, 8, 9, 10, 13, 15, 17, 20, 27, 36, 38, p45-I | 16 (88.9) | 2 (11.1)f | 12 (100) | – | 1 (50.0) | 1 (50.0) |
| Der-Ecl: 5-II, 47 | |||||||
| ESBL-Ecl: 6, 23 | |||||||
| Unidentified: 34, 35 | |||||||
| TZP | Ind-Ecl: 12, 18, 25, 29, 5-I | 5(71.4) | 2(28.6) | 4(80.0) | 1(20.0) | 1(50.0) | 1(50.0) |
| Der-Ecl: 46, 51 | |||||||
| MEM | Ind-Ecl: 42, p49 | 11 (100) | – | 2 (100) | – | 8 (100) | – |
| Der-Ecl: 3-B, 22, 30-II, 31-B, 32, 43, 44, 50 | |||||||
| Unidentified: p41 | |||||||
| IPM | Ind-Ecl: 2, 19 | 1 (50.0) | 1 (50.0) | 1 (50.0) | 1 (50.0) | – | – |
| CIP | Ind-Ecl: 1, 7, 28, 40 | 6 (100) | – | 4 (100) | – | 2 (100) | – |
| Der-Ecl: 37, 39 | |||||||
| Total | 43(84.3) | 8(15.7) | 27(87.1) | 4(12.9) | 12(80.0) | 3(20.0) | |
CRO, ceftriaxone; FEP, cefepime; TZP, piperacillin/tazobactam; MEM, meropenem; IPM, imipenem; CIP, ciprofloxacin; ESBL, extended-spectrum β-lactamase.
For patients treated with two active antibiotics after identification/antimicrobial susceptibility testing results (i.e. directed treatment), only the drug started earlier was taken into consideration (e.g. FEP for cases 4 and 20 and MEM for case p49; see Table 4).
BSI cases 5-I/-II and 30-I/-II (i.e. due to Ind-Ecl that evolved to Der-Ecl) were taken into account as different BSI episodes.
The treatment outcomes of three BSI cases due to Der-Ecl (16, 33 and p45-II) were not assessable (see Table 3).
Three BSI cases due to unidentified Ecl (34, 35 and p41) and cases due to ESBL-Ecl (6 and 23) were included (see Tables 3 and 4).
Two of these BSI cases were empirically treated with FEP (case 11 for 3 days) or MEM (case p48 for 4 days) before implementing CRO.
Case 5-II received FEP treatment 13 days after the BSI onset, whereas case 23 was due to an ESBL-Ecl (see Table 3).