@article{2999953,
    title = "In vitro activity of aztreonam/avibactam against a global collection of Klebsiella pneumoniae collected from defined culture sources in 2016 and 2017",
    author = "Esposito, S. and Stone, G.G. and Papaparaskevas, J.",
    journal = "Journal of Global Antimicrobial Resistance",
    year = "2021",
    volume = "24",
    pages = "14-22",
    publisher = "Elsevier Ireland Ltd",
    issn = "2213-7165",
    doi = "10.1016/j.jgar.2020.08.004",
    keywords = "amikacin;  avibactam;  avibactam plus ceftazidime;  aztreonam;  cefepime;  ceftazidime;  colistin;  meropenem;  antiinfective agent;  avibactam;  azabicyclo derivative;  aztreonam, abdomen;  Africa;  antibacterial activity;  antibiotic resistance;  antibiotic sensitivity;  Article;  Asia;  bacterium culture;  bacterium isolate;  blood;  broth dilution;  controlled study;  Europe;  Klebsiella pneumoniae;  lower respiratory tract;  Middle East;  minimum inhibitory concentration;  nonhuman;  priority journal;  skin;  skin structure;  South and Central America;  urinary tract, Africa;  Anti-Bacterial Agents;  Asia;  Azabicyclo Compounds;  Aztreonam;  Europe;  Klebsiella pneumoniae;  Latin America;  Middle East",
    abstract = "Objectives: This study reports on the activity of aztreonam/avibactam (ATM-AVI) against a collection of Klebsiella pneumoniae collected in 2016 and 2017. Methods: Non-duplicate K. pneumoniae isolates were collected from four regions (Africa/Middle East, n = 785; Asia-Pacific, n = 1433; Europe, n = 4236; Latin America, n = 1499) and five culture sources (blood, n = 902; intra-abdominal, n = 992; urinary tract, n = 2148; skin and skin structure, n = 1409; lower respiratory tract, n = 2502). MICs were determined at a central laboratory using Clinical and Laboratory Standards Institute (CLSI) broth microdilution methodology. Susceptibility was determined using European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints. Results: For all culture sources, against all K. pneumoniae, the highest rates of susceptibility were seen for amikacin (>84%), ceftazidime/avibactam (>94%), colistin (>92%) and meropenem (>83%), and >99.9% of isolates were inhibited at an ATM-AVI MIC of ≤4 mg/L. Among meropenem-resistant (MEM-R, n = 583) and meropenem-resistant metallo-β-lactamase-negative (MEM-R-MBLN; n = 469) isolates, susceptibility was highest to ceftazidime/avibactam (79.9% and 99.4%, respectively) and colistin (67.2% and 62.7%, respectively). All MEM-R-MBLN isolates from blood, intra-abdominal, urinary tract and skin and skin structure sources, and all but one isolate from respiratory sources, were inhibited at an ATM-AVI MIC of ≤2 mg/L. Against the meropenem-resistant metallo-β-lactamase positive (MEM-R-MBLP; n = 114) isolates, susceptibility to colistin was between 75.0% (urinary tract isolates) and 93.3% (lower respiratory tract isolates). All MEM-R-MBLP isolates were inhibited at an ATM-AVI MIC of ≤0.5 mg/L. Conclusions: ATM-AVI is active against K. pneumoniae isolates from a range of culture sources across Africa/Middle East, Asia-Pacific, Europe and Latin America. ATM-AVI also has activity against MEM-R-MBLN and MEM-R-MBLP isolates. © 2020 The Authors"
}