Antimicrobial susceptibility profile of ceftolozane/tazobactam, ceftazidime/avibactam and cefiderocol against carbapenem-resistant Pseudomonas aeruginosa clinical isolates from Türkiye.

Autor: Buyukyanbolu E; Department of Medical Microbiology, Health Sciences University Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey. nallarecem@gmail.com.; Center for Anti-Infective Research & Development, Hartford Hospital, 80 Seymour Street, Hartford, 06102, CT, USA. nallarecem@gmail.com., Genc L; Department of Medical Microbiology, Health Sciences University Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey., Cyr EA; Center for Anti-Infective Research & Development, Hartford Hospital, 80 Seymour Street, Hartford, 06102, CT, USA., Karakus M; Department of Medical Microbiology, Health Sciences University, Istanbul, Turkey., Comert F; Department of Medical Microbiology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey., Otlu B; Department of Medical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey., Aktas E; Department of Medical Microbiology, Health Sciences University Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey., Nicolau DP; Center for Anti-Infective Research & Development, Hartford Hospital, 80 Seymour Street, Hartford, 06102, CT, USA.
Jazyk: angličtina
Zdroj: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology [Eur J Clin Microbiol Infect Dis] 2024 Sep; Vol. 43 (9), pp. 1787-1794. Date of Electronic Publication: 2024 Jul 12.
DOI: 10.1007/s10096-024-04896-7
Abstrakt: Purpose: Carbapenem resistant Pseudomonas aeruginosa (CR-PA) is escalating worldwide and leaves clinicians few therapeutic options in recent years, β-lactam/β-lactamase inhibitor combinations (ceftolozane-tazobactam, ceftazidime-avibactam) and a new siderophore cephalosporin (cefiderocol) have been approved for the treatment of P. aeruginosa infection and have shown potent activity against isolates defined as carbapenem resistant. The aim of this study was to determine the phenotypic profile of these agents against CR-PA in the emerging setting of carbapenemases.
Methods: CR-PA clinical isolates were collected from three teaching hospitals in different geographical regions between January 2017-December 2021. All isolates were subjected to phenotypic carbapenemase testing using modified carbapenem inactivation method. MICs were determined by reference broth microdilution and evaluated according to EUCAST standards, while genotypic profiling was determined using PCR methods.
Results: 244 CR-PA sourced most frequently from the respiratory tract (32.2%), blood (20.4%) and urine (17.5%) were evaluated. Of all isolates, 32 (13.1%) were phenotypically and 38 (15.6%) were genotypically defined as carbapenemase-positive. The most common carbapenemase was GES (63.1%), followed by VIM (15.8%). The MIC 50/90 (S%) of ceftazidime/avibactam, ceftolozane/tazobactam and cefiderocol in all CR-PA isolates were 4 and 32 (80%), 1 and > 64 (69%) and 0.25 and 1 mg/L (96%), respectively. Cefiderocol was also the most active agent in carbapenemase-positive isolates (90%).
Conslusion: While ceftolozane/tazobactam and ceftazidime/avibactam remained highly active against CR-PA devoid of carbapenemases, cefiderocol provided potent in vitro activity irrespective of carbapenemase production. When considering the potential clinical utility of newer agents against CR-PA, regional variations in carbapenemase prevalence must be considered.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: