• Uğur Önal, Nazmiye Ülkü Tüzemen, Pınar Küçükdemirci Kaya, Remzi İşçimen, GirginNermin KelebekNK0000-0002-5882-1632Uludag University, Faculty of Medicine, Department of Anesthesiology and Reanimation - Bursa, Turkey., Cüneyt Özakın, Ferda Şöhret Kahveci, and Halis Akalın.
• Uludag University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology - Bursa, Turkey.
• Rev Assoc Med Bras (1992). 2023 Jan 1; 69 (11): e20230727e20230727.

ObjectiveThe aim of this study was to evaluate the combination treatments with intravenous fosfomycin for carbapenem-resistant Klebsiella pneumoniae infections in a tertiary-care center.MethodsBetween December 24, 2018 and November 21, 2022, adult patients diagnosed with bloodstream infection or ventilator-associated pneumonia due to culture-confirmed carbapenem-resistant Klebsiella pneumoniae in the anesthesiology and reanimation intensive care units were investigated retrospectively.ResultsThere were a total of 62 patients fulfilling the study inclusion criteria. No significant difference was recorded in 14- and 30-day mortality among different types of combination regimens such as fosfomycin plus one or two antibiotic combinations. Hypokalemia (OR:5.651, 95%CI 1.019-31.330, p=0.048) was found to be a significant risk factor for 14-day mortality, whereas SOFA score at the time of diagnosis (OR:1.497, 95%CI 1.103-2.032, p=0.010) and CVVHF treatment (OR:6.409, 95%CI 1.395-29.433, p=0.017) were associated with 30-day mortality in multivariate analysis.ConclusionIn our study, high mortality rates were found in patients with bloodstream infection or ventilator-associated pneumonia due to carbapenem-resistant Klebsiella pneumoniae, and no significant difference was recorded in 14- and 30-day mortality among different types of combination regimens such as fosfomycin plus one or two antibiotic combinations.

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