Background

The role of piperacillin/tazobactam for treatment of serious infections due to AmpC-producing organisms remains debatable, particularly in immunocompromised patients.

Methods

This was a retrospective cohort study in immunocompromised patients that investigated the effect of definitive treatment with either piperacillin/tazobactam versus cefepime or carbapenems for bacteraemia caused by cefoxitin-non-susceptible Enterobacterales. The primary endpoint was a composite of clinical and microbiological failure. A logistic regression model was constructed to assess the impact of definitive treatment choice on the primary endpoint.

Results

A total of 81 immunocompromised patients with blood cultures positive for cefoxitin-non-susceptible Enterobacterales were included for analysis. There was more microbiological failure in the piperacillin/tazobactam arm compared with the cefepime/carbapenem arm (11.4% versus 0.0%, P = 0.019). Definitive treatment with cefepime or a carbapenem was associated with a decreased odds of clinical or microbiological failure (OR 0.303, 95% CI 0.093-0.991, P = 0.048) when controlling for baseline characteristics.

Conclusions

In immunocompromised patients with bacteraemia due to cefoxitin-non-susceptible Enterobacterales, definitive treatment with piperacillin/tazobactam was associated with an increased risk of microbiological failure and higher odds of clinical or microbiological failure compared with cefepime or carbapenems.

Children with autism have impairments in communication and social interactions. Past studies have shown that robotbasedinterventions are effective in improving their gestural use. The present study asked whether or not children with autismcould meet the level of gestural production found in age-matched children with typical development after intervention.Four- to six-year-old children with autism in the intervention group (N = 15) took four training sessions in which theyimitated the gestures demonstrated by a social robot in various narratives. Age-matched children with autism in the wait-list control group (N = 15) and children with typical development (N = 15) received the training after the completion of theresearch. Children with autism in the intervention condition produced gestures more accurately in the training and novelstories than those in the wait-list control group in the posttests. Even more promising, the level of gestural productionaccuracy in children with autism in the delayed posttest of novel stories was comparable to that in children with typicaldevelopment, suggesting that children with autism could catch up to the level of gestural production found in children withtypical development.