Multidrug-resistant Pseudomonas aeruginosa from sputum of patients with cystic fibrosis demonstrates a high rate of susceptibility to ceftazidime-avibactam.

Autor: Atkin SD; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA, raksha.jain@utsouthwestern.edu., Abid S; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA, raksha.jain@utsouthwestern.edu., Foster M; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA, raksha.jain@utsouthwestern.edu., Bose M; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA, raksha.jain@utsouthwestern.edu., Keller A; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA, raksha.jain@utsouthwestern.edu., Hollaway R; Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA., Sader HS; JMI Laboratories, North Liberty, IA, USA., Greenberg DE; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA, raksha.jain@utsouthwestern.edu.; Department of Microbiology, University of Texas Southwestern Medical Center, Dallas, TX, USA, raksha.jain@utsouthwestern.edu., Finklea JD; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA, raksha.jain@utsouthwestern.edu., Castanheira M; JMI Laboratories, North Liberty, IA, USA., Jain R; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA, raksha.jain@utsouthwestern.edu.; Department of Microbiology, University of Texas Southwestern Medical Center, Dallas, TX, USA, raksha.jain@utsouthwestern.edu.
Jazyk: angličtina
Zdroj: Infection and drug resistance [Infect Drug Resist] 2018 Sep 17; Vol. 11, pp. 1499-1510. Date of Electronic Publication: 2018 Sep 17 (Print Publication: 2018).
DOI: 10.2147/IDR.S173804
Abstrakt: Purpose: Ceftazidime-avibactam is a novel antimicrobial combining a third-generation cephalosporin with a non-β-lactam β-lactamase inhibitor that was recently approved to treat Gram-negative hospital- and ventilator-acquired pneumonia. The use of ceftazidime-avibactam to treat Pseudomonas aeruginosa respiratory infections in patients with cystic fibrosis (CF) has not been evaluated. In this study, we assessed the ceftazidime-avibactam susceptibility of multidrug-resistant (MDR) P. aeruginosa sputum isolates from adults with CF.
Methods: Sputum was collected from individuals with CF, aged ≥18 years, known to be colonized with MDR P. aeruginosa , and tested for susceptibility to 11 different antipseudomonal antimicrobial agents. Isolates were included in the analysis if they were resistant to both ceftazidime and at least one agent in ≥3 different antimicrobial categories routinely used to treat P. aeruginosa . Subject demographics and clinical characteristics were collected. Ceftazidime-avibactam-resistant isolates were screened for the presence of β-lactam-resistant mechanisms.
Results: Thirty-two P. aeruginosa isolates were analyzed, of which 23 isolates were sensitive to ceftazidime-avibactam (71.9%). Ten of the isolates were mucoid and 22 isolates were nonmucoid, both demonstrating >70% susceptibility to ceftazidime-avibactam. The most notable difference in the subjects with resistant strains was an older age and lower body mass index (BMI). Ceftazidime-avibactam-resistant strains showed elevated AmpC expression in >60% of the strains and loss of OprD detection in >70% of the strains.
Conclusion: Ceftazidime-avibactam demonstrated a significant in vitro activity against highly resistant P. aeruginosa sputum isolates from individuals with CF. Further evaluation of the cause of resistance and clinical impact of ceftazidime-avibactam in CF patients with MDR P. aeruginosa is warranted.
Competing Interests: Disclosure The authors report no conflicts of interest in this work.
Databáze: MEDLINE