Italian nationwide survey on pseudomonas aeruginosa from invasive infections: Activity of ceftolozane/tazobactam and comparators, and molecular epidemiology of carbapenemase producers

Autor: Tommaso Giani, C Giraldi, Marco Maria D'Andrea, Claudio Farina, Antonella Mencacci, R Rigoli, Mario Sarti, Fabio Arena, Gian Maria Rossolini, Vincenzo Di Pilato, Mario Rassu, Patrizia Pecile, Elisabetta Pagani, Esther Manso, G. Amato, Rossana Cavallo, C Vismara, Lucia Henrici De Angelis, Matteo Bassetti, P.A. Dusi, Maria Grazia Cusi, Teresa Spanu, Simona Pollini, Stefania Stefani, Francesco Luzzaro, Claudio Scarparo, Maria Labonia, Tassi
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Microbiology (medical)
DNA
Bacterial
Tazobactam
medicine.drug_class
030106 microbiology
Cephalosporin
Drug Resistance
Anti-Bacterial Agents
Bacteremia
Bacterial Proteins
Cephalosporins
Cross Infection
Drug Resistance
Multiple
Bacterial
Epidemiological Monitoring
Humans
Italy
Microbial Sensitivity Tests
Pseudomonas Infections
Pseudomonas aeruginosa
Respiratory Tract Infections
Whole Genome Sequencing
beta-Lactamases
Drug resistance
Biology
medicine.disease_cause
xx
Settore BIO/19 - Microbiologia Generale
Microbiology
03 medical and health sciences
Pharmacology
Pharmacology (medical)
Infectious Diseases
medicine
Broth microdilution
Bacterial
CETOZOLANE-TAZOBACTAM
DNA
Settore MED/07 - Microbiologia e Microbiologia Clinica
Amikacin
Colistin
Ceftolozane
Multiple
medicine.drug
Popis: Objectives Pseudomonas aeruginosa is a major cause of severe healthcare-associated infections and often shows MDR phenotypes. Ceftolozane/tazobactam is a new cephalosporin/β-lactamase inhibitor combination with potent activity against P. aeruginosa. This survey was carried out to evaluate the susceptibility of P. aeruginosa, circulating in Italy, to ceftolozane/tazobactam and comparators and to investigate the molecular epidemiology of carbapenemase-producing strains. Methods Consecutive non-replicate P. aeruginosa clinical isolates (935) from bloodstream infections and lower respiratory tract infections were collected from 20 centres distributed across Italy from September 2013 to November 2014. Antimicrobial susceptibility testing was performed by broth microdilution and results were interpreted according to the EUCAST breakpoints. Isolates resistant to ceftolozane/tazobactam were investigated for carbapenemase genes by PCR, and for carbapenemase activity by spectrophotometric assay. WGS using an Illumina platform was performed on carbapenemase-producing isolates. Results Ceftolozane/tazobactam was the most active molecule, retaining activity against 90.9% of P. aeruginosa isolates, followed by amikacin (88.0% susceptibility) and colistin (84.7% susceptibility). Overall, 48 isolates (5.1%) were positive for carbapenemase genes, including blaVIM (n = 32), blaIMP (n = 12) and blaGES-5 (n = 4), while the remaining ceftolozane/tazobactam-resistant isolates tested negative for carbapenemase production. Carbapenemase producers belonged to 10 different STs, with ST175 (n = 12) and ST621 (n = 11) being the most common lineages. Genome analysis revealed different trajectories of spread for the different carbapenemase genes. Conclusions Ceftolozane/tazobactam exhibited potent in vitro activity against P. aeruginosa causing invasive infections in Italy. Carbapenemase production was the most common mechanism of resistance to ceftolozane/tazobactam.
Databáze: OpenAIRE
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