The first aim of this study is to explore the drug resistance mechanism of Enterobacteriaceae bacteria and to evaluate the treatment effect of ceftazidime-avibactam (CAZ-AVI) in combination with aztreonam (ATM) against Metallo-β-lactamases (MBL) producing Enterobacterales in vivo. The investigators then use CRISPR/Cas9 technology to remove Enterobacteriaceae bacteria resistance and virulence genes
Clinical information of subjects, including diseases, departments, medication history, days of hospitalization, and treatment outcomes will be collected; Bacterial species names will be identified and drugs sensitivity will be detected; For patients with bloodstream infection of MBL-producing Enterobacterales, ceftazidime-avibactam (CAZ-AVI) was administered at the dose of 2.5 g every 8 hours and aztreonam (ATM) at the dose of 2 g every 8 hours. The primary outcome measure was 30-day all-cause mortality, while secondary outcomes were clinical failure at day 14 and length of stay (LOS) after bloodstream infection diagnosis. Cox regression analysis, including a propensity score (PS) for receiving CAZ-AVI plus ATM, was conducted to assess the primary and secondary outcomes. The CRISPR/Cas9 gene curation technology was used to eliminate the drug resistance and virulence factors of Enterobacteriaceae in the mouse intestinal colonization model.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
427
Samples of the patients will be examined such as the routine blood test, blood culture et al.
Conventional treatment
Mingju Hao
Jinan, Shandong, China
RECRUITING30-day all-cause mortality
The primary outcome measure was 30-day all-cause mortality
Time frame: two years
clinical failure at day 14
severe comorbidities, mechanical ventilation or septic shock at day 14
Time frame: two years
length of stay after diagnosis
length of stay (LOS) after blood stream infection diagnosis
Time frame: two years
Positive rate of Metallo-β-lactamases (MBL) producing Enterobacterales
Positive rate and subtype distribution of Metallo-β-lactamases (MBL) producing Enterobacterales
Time frame: two years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.