In vitro activity of ceftazidime/avibactam and comparators against carbapenemase-producing Enterobacterales and Pseudomonas aeruginosa isolates collected globally between 2016 and 2018. (December 2021)

• Record Type: Journal Article
• Authors: Kiratisin, Pattarachai; Kazmierczak, Krystyna; Stone, Gregory G.
• Is Part Of: Journal of global antimicrobial resistance. Volume 27(2021)
• Page Start: 132
• Page End: 141
• Publication Date: 2021-12
• Subjects: Ceftazidime/avibactam -- Enterobacterales -- Pseudomonas aeruginosa -- Antimicrobial susceptibility -- Carbapenemase -- Metallo-β-lactamase; Drug resistance -- Periodicals; Drug resistance -- Periodicals; Drug resistance; Periodicals; 616.9041
• DOI: 10.1016/j.jgar.2021.08.010
• Languages: English
• ISSNs: 2213-7165

Abstract

Highlights: Regions studied: Africa/Middle East, Asia/South Pacific, Europe and Latin America. 1992 carbapenemase-producing Enterobacterales (CPE) were collected. ≤4.5% of MBL-negative CPE were resistant to ceftazidime/avibactam (CZA). 784 carbapenemase-producing Pseudomonas aeruginosa isolates were collected. 8.6% (Europe) and 53.2% (Latin America) carbapenemase-producing, MBL-negative P. aeruginosa were resistant to CZA. 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.