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Enterococcal superinfection and colonization with aztreonam therapy
Abstract:
Patients were given aztreonam (SQ 26,776) parenterally for the treatment of various gram-negative infections. During or shortly after therapy, 8 (17.8%) of 45 patients became infected with or colonized by enterococcus. These eight cases included eight urinary tract isolates; one of these cases subsequently developed bacteremia. Five patients required further antimicrobial therapy directed against enterococcus. Patients receiving aztreonam are at risk for the development of enterococcal superinfection or colonization.
Insights
Aztreonam treatment for gram-negative infections can lead to enterococcal superinfections. About 18% of patients developed enterococcal colonization or infection, with some cases progressing to bacteremia.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Aztreonam is a potent monobactam antibiotic effective against Gram-negative bacteria.
- Gram-negative infections often require parenteral antibiotic therapy.
- Emergence of secondary infections during antibiotic treatment is a clinical concern.
Purpose of the Study:
- To investigate the incidence of enterococcal superinfection or colonization in patients treated with aztreonam.
- To assess the clinical implications of enterococcal overgrowth during aztreonam therapy.
Main Methods:
- Prospective observational study involving 45 patients.
- Patients received parenteral aztreonam for Gram-negative infections.
- Monitoring for enterococcal infection or colonization during and after treatment.
Main Results:
- Eight out of 45 patients (17.8%) developed enterococcal infection or colonization.
- All eight cases involved urinary tract isolates.
- One patient subsequently developed enterococcal bacteremia.
- Five patients required additional antimicrobial treatment for enterococcus.
Conclusions:
- Parenteral aztreonam therapy is associated with a significant risk of enterococcal superinfection or colonization.
- Healthcare providers should monitor patients on aztreonam for signs of enterococcal overgrowth.
- Enterococcal superinfection may necessitate further targeted antimicrobial therapy.