In vitro activity of ceftazidime/avibactam and comparators against carbapenemase-producing Enterobacterales and Pseudomonas aeruginosa isolates collected globally between 2016 and 2018

Content Provider	Directory of Open Access Journals (DOAJ)
Author	Pattarachai Kiratisin Krystyna Kazmierczak Gregory G. Stone
Abstract	ABSTRACT: Objectives: This study reports the antimicrobial activity of ceftazidime/avibactam (CZA) and comparators against carbapenemase-producing Enterobacterales (N = 1992) and carbapenemase-producing Pseudomonas aeruginosa (N = 784) collected in Africa/Middle East, Asia/South Pacific, Europe and Latin America (2016–2018).Methods: Minimum inhibitory concentrations (MICs) and susceptibility were determined using broth microdilution methodology and EUCAST breakpoints. Carbapenemase-encoding genes were detected using multiplex PCR.Results: No isolates of carbapenemase-producing, metallo-β-lactamase (MBL)-negative Enterobacterales from Africa/Middle East or Latin America were resistant to CZA; resistance rates in Europe and Asia/South Pacific were ≤4.5%. Colistin had the lowest resistance rate among MBL-positive isolates (6.0–11.4%). Enterobacterales isolates collected in Latin America predominantly carried a KPC carbapenemase (77.6%), whereas in Africa/Middle East OXA-48-like carbapenemases were most frequently detected (55.9%), and in Asia/South Pacific most isolates carried NDM carbapenemases (56.2%). Among all Enterobacterales carrying KPC carbapenemases, the lowest rate of resistance was to CZA (1.5%), and among isolates carrying NDM carbapenemases it was to colistin (10.8%). Among carbapenemase-producing, MBL-negative P. aeruginosa, resistance rates to CZA were 8.6% for isolates collected in Europe and 53.2% in Latin America. Isolates in each region most frequently carried VIM carbapenemases, ranging from 41.7% of isolates in Asia/South Pacific to 86.2% in Africa/Middle East. No P. aeruginosa carrying KPC or NDM carbapenemases and 1.0% of isolates carrying GES carbapenemases were resistant to colistin.Conclusion: Given the limited therapeutic options to treat infections caused by carbapenemase-positive Enterobacterales and P. aeruginosa, continued surveillance of CZA activity as well as agents such as colistin is crucial.
Related Links	http://www.sciencedirect.com/science/article/pii/S2213716521002022
ISSN	22137165
DOI	10.1016/j.jgar.2021.08.010
Journal	Journal of Global Antimicrobial Resistance
Volume Number	27
Language	English
Publisher	Elsevier
Publisher Date	2021-01-01
Publisher Place	United Kingdom
Access Restriction	Open
Subject Keyword	Microbiology Ceftazidime/avibactam Enterobacterales Pseudomonas Aeruginosa Antimicrobial Susceptibility Carbapenemase Metallo-β-lactamase
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology Microbiology Microbiology (medical)