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1587. Activity of Ceftolozane/Tazobactam against Gram-Negative Isolates from Lower Respiratory Tract Infections – SMART United States 2018
| Content Provider | Oxford Academic |
|---|---|
| Author | Lob, Sibylle Hackel, Meredith DePestel, Daryl Young, Katherine Motyl, Mary Sahm, Daniel F |
| Copyright Year | 2020 |
| Abstract | Background: Ceftolozane/tazobactam (C/T) is an antipseudomonal cephalosporin combined with a β-lactamase inhibitor. C/T has been approved by the FDA and EMA for complicated urinary tract infections, complicated intraabdominal infections, and hospital-acquired and ventilator-associated bacterial pneumonia. Using isolates collected in the United States as part of the global SMART surveillance program, we evaluated the activity of C/T and comparators against gram-negative pathogens collected from patients with lower respiratory tract infections (LRTI).MethodsIn 2018, 24 hospitals in the US each collected up to 100 consecutive aerobic or facultative gram-negative bacilli (GNB) from LRTI for a total of 1773 isolates. MICs were determined using CLSI broth microdilution and breakpoints. C/T-nonsusceptible (NS) Enterobacterales and P. aeruginosa isolates were screened by PCR and sequencing for genes encoding β-lactamases.ResultsThe 3 most common species collected from LRTI were P. aeruginosa (35.0% of all collected GNB), K. pneumoniae (10.4%), and E. coli (9.6%). Enterobacterales and P. aeruginosa combined comprised 86.3% of all collected LRTI GNB. The activity of C/T and comparators against GNB from LRTI is shown in the table.C/T was active against 93% of Enterobacterales isolates from LRTI (activity only exceeded by meropenem and amikacin), as well as against 97% of P. aeruginosa and 94% of all Enterobacterales and P. aeruginosa combined (activity only exceeded by amikacin). C/T maintained activity against 69-83% of β-lactam-NS subsets of Enterobacterales and P. aeruginosa combined.Among 67 molecularly characterized C/T-NS Enterobacterales isolates, 19.4% carried KPC, 1.5% acquired AmpC, and 16.4% only extended-spectrum β-lactamases. No acquired β-lactamases were detected in the remaining 62.7% of isolates, of which 92.9% were species with intrinsic AmpC. Among 21 molecularly characterized C/T-NS P. aeruginosa, one isolate carried an IMP-type metallo-β-lactamase, and in the remaining isolates no acquired β-lactamases were detected.TableConclusionWith its broad coverage of Enterobacterales and P. aeruginosa, C/T can provide an important empiric therapy option for patients with LRTI in the US.DisclosuresSibylle Lob, PhD, IHMA (Employee)Pfizer, Inc. (Consultant) Daryl DePestel, PharmD, BCPS-ID, Merck & Co, Inc (Employee) Katherine Young, MS, Merck & Co., Inc. (Employee, Shareholder)Merck & Co., Inc. (Employee, Shareholder) Mary Motyl, PhD, Merck & Co, Inc (Employee, Shareholder) Daniel F. Sahm, PhD, IHMA (Employee)Pfizer, Inc. (Consultant)Shionogi & Co., Ltd. (Independent Contractor) |
| Related Links | https://academic.oup.com/ofid/article-pdf/7/Supplement_1/S790/35343714/ofaa439.1767.pdf |
| Ending Page | S791 |
| Starting Page | S790 |
| File Format | |
| e-ISSN | 23288957 |
| DOI | 10.1093/ofid/ofaa439.1767 |
| Journal | Open Forum Infectious Diseases |
| Issue Number | Suppl_1 |
| Volume Number | 7 |
| Language | English |
| Publisher | Oxford Academic |
| Publisher Date | 2020-12-31 |
| Access Restriction | Open |
| Subject Keyword | Clinical Medicine Infectious Diseases Medicine and Health Lower Respiratory Tract Infections Tazobactam Employee Ceftolozane Amikacin Consultants Disclosure Genes Lactams United States Food and Drug Administration Ventilators, Mechanical Bacterial Pneumonia Urinary Tract Infections Meropenem Pathogenic Organism Doctor of Pharmacy Polymerase Chain Reaction Abdominal Infections Surveillance Program Gram-negative Bacillus Malnutrition-inflammation-cachexia Syndrome |
| Content Type | Text |
| Resource Type | Article |
| Subject | Oncology Infectious Diseases |
