Τίτλος:
The ERACE-PA Global Surveillance Program: Ceftolozane/tazobactam and
Ceftazidime/avibactam in vitro Activity against a Global Collection of
Carbapenem-resistant Pseudomonas aeruginosa
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The cephalosporin-beta-lactamase-inhibitor-combinations,
ceftolozane/tazobactam and ceftazidime/avibactam, have revolutionized
treatment of carbapenem-resistant Pseudomonas aeruginosa (CR-PA). A
contemporary assessment of their in vitro potency against a global CR-PA
collection and an assessment of carbapenemase diversity are warranted.
Isolates determined as CR-PA by the submitting site were collected from
2019-2021 (17 centers in 12 countries) during the ERACE-PA Global
Surveillance Program. Broth microdilution MICs were assessed per CLSI
standards for ceftolozane/tazobactam, ceftazidime/avibactam,
ceftazidime, and cefepime. Phenotypic carbapenemase testing was
conducted (modified carbapenem inactivation method (mCIM)). mCIM
positive isolates underwent genotypic carbapenemase testing using the
CarbaR, the CarbaR NxG, or whole genome sequencing. The MIC50/90 was
reported as well as percent susceptible (CLSI and EUCAST
interpretation). Of the 807 isolates, 265 (33%) tested
carbapenemase-positive phenotypically. Of these, 228 (86%) were
genotypically positive for a carbapenemase with the most common being
VIM followed by GES. In the entire cohort of CR-PA,
ceftolozane/tazobactam and ceftazidime/avibactam had MIC50/90 values of
2/ > 64 and 4/64 mg/L, respectively. Ceftazidime/avibactam was the most
active agent with 72% susceptibility per CLSI compared with 63% for
ceftolozane/tazobactam. For comparison, 46% of CR-PA were susceptible
to ceftazidime and cefepime. Against carbapenemase-negative isolates, 88
and 91% of isolates were susceptible to ceftolozane/tazobactam and
ceftazidime/avibactam, respectively. Ceftolozane/tazobactam and
ceftazidime/avibactam remained highly active against
carbapenem-resistant P. aeruginosa, particularly in the absence of
carbapenemases. The contemporary ERACE-PA Global Program cohort with
33% carbapenemase positivity including diverse enzymology will be
useful to assess therapeutic options in these clinically challenging
organisms with limited therapies.
Συγγραφείς:
Gill, Christian M.
Aktap, Elif
Alfouzan, Wadha
Bourassa,
Lori
Brink, Adrian
Burnham, Carey-Ann D.
Canton, Rafael and
Carmeli, Yehuda
Falcone, Marco
Kiffer, Carlos
Marchese, Anna
and Martinez, Octavio
Pournaras, Spyros
Satlin, Michael and
Seifert, Harald
Thabit, Abrar K.
Thomson, Kenneth S. and
Villegas, Maria Virginia
Nicolau, David P.
ERACE PA Global Study
Grp
Περιοδικό:
European Journal of Clinical Microbiology & Infectious Diseases
Λέξεις-κλειδιά:
Carbapenem-resistant P; aeruginosa; Ceftazidime; avibactam; Ceftolozane;
tazobactam; Carbapenemase
DOI:
10.1007/s10096-021-04308-0
