In vitro activity of ceftolozane/tazobactam against Gram‐negative isolates collected from ICU patients with lower respiratory tract infections in seven Asian countries—SMART 2017–2019. (June 2022)

• Record Type: Journal Article
• Authors: Lob, Sibylle H.; Kazmierczak, Krystyna M.; Chen, Wei-Ting; Siddiqui, Fakhar; DeRyke, C. Andrew; Young, Katherine; Motyl, Mary R.; Sahm, Daniel F.
• Is Part Of: Journal of global antimicrobial resistance. Volume 29(2022)
• Page Start: 527
• Page End: 533
• Publication Date: 2022-06
• Subjects: SMART -- Ceftolozane/tazobactam -- Gram-negative bacilli -- Asia -- Intensive care unit -- Lower respiratory tract infection; Drug resistance -- Periodicals; Drug resistance -- Periodicals; Drug resistance; Periodicals; 616.9041
• DOI: 10.1016/j.jgar.2021.11.011
• Languages: English
• ISSNs: 2213-7165

Abstract

Highlights: The study focused on ICU patients with respiratory tract infections (LRTIs) in Asia. Ceftolozane/tazobactam (C/T) was active against 72% of Enterobacterales. C/T was active against 86% of all and 61% of meropenem-nonsusceptible Pseudomonas aeruginosa. Activity of C/T was lowest in Thailand and Vietnam, where carbapenemase rates were high. C/T provides a potential treatment option for ICU patients with LRTI in Asia. Abstract: Objectives: Antimicrobial resistance is one of the top 10 global public-health threats. Especially high rates of resistance have been reported for isolates from ICU patients, requiring expanded treatment options in this setting. We evaluated the activity of ceftolozane/tazobactam and comparators against Gram-negative isolates collected from patients with lower respiratory tract infections (LRTIs) in ICUs in seven Asian countries. Methods: In 2017–2019, up to 100 consecutive, aerobic Gram-negative LRTI isolates were collected per year at each of 37 hospitals. MICs were determined using the Clinical and Laboratory Standards Institute reference broth microdilution method. Results: Overall, ceftolozane/tazobactam was active against 72% of 1408 Enterobacterales and 86% of 761 Pseudomonas aeruginosa isolates. Susceptibility to the non-carbapenem β-lactam comparators, including piperacillin/tazobactam, was 52–67% among Enterobacterales isolates, and the activity of all β-lactam comparators, including meropenem, was 57–70% among P. aeruginosa . Ceftolozane/tazobactam maintained activity against 61% of meropenem-nonsusceptible and 64% of piperacillin/tazobactam-nonsusceptible P. aeruginosa . At the country-level, ceftolozane/tazobactam activity ranged from >90% against Enterobacterales from Hong Kong and South Korea to <64% in Thailand and Vietnam, and from >90% against P. aeruginosa from South Korea, Malaysia, Philippines and Taiwan to <75% in Thailand and Vietnam. Correspondingly, the proportions of carbapenemase-positive isolates among Enterobacterales and P. aeruginosa isolates were highest in Thailand and Vietnam. Conclusion: Ceftolozane/tazobactam provides a potential treatment option for ICU patients in Asia, which is especially important considering the reduced activity of commonly used β-lactams against the studied ICU isolates. Knowledge of local resistance patterns should inform empirical therapy decision-making.