We present our retrospective case series of eight patients with either bloodstream infection, pneumonia or complicated intra-abdominal infection caused by extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) treated with cefepime/enmetazobactam. Treatment failure and 30-day all-cause mortality occurred in one patient each. Cefepime/enmetazobactam showed favorable clinical results and may represent a carbapenem-sparing treatment option in selected patients with invasive ESBL-E infections. Real-world data remain limited and further studies are needed to specify the most suitable patient population.
This study aimed to evaluate the effectiveness and safety of cefazolin prophylactic regimen versus standard penicillin treatment in pregnant women colonized with GBS(Group B Streptococcus), and further analyzed the timing of intrapartum antibiotic prophylaxis. We retrospectively analyzed the singleton pregnant women with GBS colonization at 35–37 weeks of gestation in Shenzhen Baoan Women’s and Children’s Hospital between September 2018 and January 2024. 2653 pregnant women received standardized penicillin prophylaxis and 2418 pregnant women received alternative cefazolin prophylaxis in labor. Maternal and neonatal outcomes were compared between the two different intrapartum antibiotic prophylaxis (IAP) groups. No significant differences were found in postpartum hemorrhage, amniotic fluid fecal contamination, delivery assistance, neonatal sepsis, neonatal asphyxia and Apgar score between Penicillin group and Cefazolin group (P > 0.05). In terms of chorioamnionitis, neonatal pneumonia, cesarean section, neonatal jaundice and NICU admission, the cefazolin group showed significantly lower rates than that of penicillin group(P < 0.05). The incidence of chorioamnionitis, transfer to cesarean section and NICU admission in both penicillin and cefazolin IAP subgroup of more than 4 h were lower than that of less than or equal 4 h, however with no significantly difference when using cefazolin about chorioamnionitis. Our study shows that cefazolin is effective and safe as penicillin in preventing maternal-fetal GBS infection and may be used as an alternative antibiotics. In addition, it is supposed that IAP should be administered during labor for at least 4h prior to delivery.
Persistent candidemia remains incompletely understood, with inconsistent definitions and conflicting evidence on outcomes. We aimed to identify factors associated with persistent candidemia and to assess its impact on complications and 30-day mortality in a single-centre cohort. We conducted a retrospective matched cohort study including patients aged ≥ 14 years with at least one positive peripheral blood culture for Candida species (September 2014-September 2024) at a 900-bed tertiary hospital in Valencia, Spain. Persistent candidemia was defined as isolation of the same Candida species from blood cultures obtained ≥ 5 days after initiation of appropriate antifungal therapy. A total of 105 patients with persistent candidemia were compared with 105 with non-persistent candidemia, matched by Charlson comorbidity index. Multivariable logistic regression identified factors independently associated with persistence and 30-day mortality. Persistent candidemia was identified in 105/515 (20.4
