In vitro activity of imipenem/relebactam against Pseudomonas aeruginosa isolates recovered from ICU patients in Spain and Portugal (SUPERIOR and STEP studies)
| Autor: | Hernández-García, Marta, García-Castillo, María, Melo-Cristino, José, Pinto, Margarida F., Gonçalves, Elsa, Alves, Valquíria, Vieira, Ana Raquel, Ramalheira, Elmano, Sancho, Luisa, Diogo, José, Ferreira, Rui, Cruz, Hugo, Chaves, Catarina, Bou, Germán, Cercenado, Emilia, Delgado-Valverde, Mercedes, Oliver, Antonio, Pitart, Cristina, Rodríguez Lozano, Jesús, Tormo, Nuria, Díaz-Regañón, Jazmín, Pássaro, Leonor, Duarte, Joana, Cantón, Rafael, STEP study group, SUPERIOR study group |
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| Přispěvatelé: | MSD, Instituto de Salud Carlos III, Ministerio de Economía y Competitividad (España), Red Española de Investigación en Patología Infecciosa, European Commission, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (España), Hernández-García, Marta, Delgado-Valverde, Mercedes, Pássaro, Leonor, Cantón, Rafael |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | The Journal of antimicrobial chemotherapy. 77(11) |
| ISSN: | 1460-2091 |
| Popis: | [Objectives] To study the in vitro activity of imipenem/relebactam and comparators and the imipenem/relebactam resistance mechanisms in a Pseudomonas aeruginosa collection from Portugal (STEP, 2017-18) and Spain (SUPERIOR, 2016-17) surveillance studies. [Methods] P. aeruginosa isolates (n = 474) were prospectively recovered from complicated urinary tract (cUTI), complicated intra-abdominal (cIAI) and lower respiratory tract (LRTI) infections in 11 Portuguese and 8 Spanish ICUs. MICs were determined (ISO broth microdilution). All imipenem/relebactam-resistant P. aeruginosa isolates (n = 30) and a subset of imipenem/relebactam-susceptible strains (n = 32) were characterized by WGS. [Results] Imipenem/relebactam (93.7% susceptible), ceftazidime/avibactam (93.5% susceptible) and ceftolozane/tazobactam (93.2% susceptible) displayed comparable activity. The imipenem/relebactam resistance rate was 6.3% (Portugal 5.8%; Spain 8.9%). Relebactam restored imipenem susceptibility to 76.9% (103/134) of imipenem-resistant isolates, including MDR (82.1%; 32/39), XDR (68.8%; 53/77) and difficult-to-treat (DTR) isolates (67.2%; 45/67). Among sequenced strains, differences in population structure were detected depending on the country: clonal complex (CC)175 and CC309 in Spain and CC235, CC244, CC348 and CC253 in Portugal. Different carbapenemase gene distributions were also found: VIM-20 (n = 3), VIM-1 (n = 2), VIM-2 (n = 1) and VIM-36 (n = 1) in Spain and GES-13 (n = 13), VIM-2 (n = 3) and KPC-3 (n = 2) in Portugal. GES-13-CC235 (n = 13) and VIM type-CC175 (n = 5) associations were predominant in Portugal and Spain, respectively. Imipenem/relebactam showed activity against KPC-3 strains (2/2), but was inactive against all GES-13 producers and most of the VIM producers (8/10). Mutations in genes affecting porin inactivation, efflux pump overexpression and LPS modification might also be involved in imipenem/relebactam resistance. [Conclusions] Microbiological results reinforce imipenem/relebactam as a potential option to treat cUTI, cIAI and LRTI caused by MDR/XDR P. aeruginosa isolates, except for GES-13 and VIM producers. The study was funded by MSD Portugal (protocol VP6918) and MSD Spain (protocol MSD-CEF-2016-01). This study was also supported by Plan Nacional de I+D+i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (RD16/0016/0001, RD16/0016/0004, RD16/0016/0006, RD16/0016/0007, RD16/0016/0010 and REIPI RD16/0016/0011), co-financed by the European Development Regional Fund ‘A way to achieve Europe’ (ERDF), Operative program Intelligent Growth 2014–2020 and CIBER de Enfermedades Infecciosas (CIBERINFEC) (CB21/13/00084), Instituto de Salud Carlos III, Madrid, Spain. |
| Databáze: | OpenAIRE |
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