BackgroundThe most common etiological agents of infections in onco-hematological patients are Gram-negative rods resistant to many antimicrobials, including carbapenems. Recently, ceftolozane combined with tazobactam became a novel therapeutic option. The aim of the present study was to analyze the susceptibility to ceftolozane/tazobactam of the clinical strains of these bacteria.Material/MethodsMaterial comprised rectal swabs, urine, and bronchoalveolar lavage fluid obtained from onco-hematological patients hospitalized in a clinical hospital (1050 beds) in Poland. Identification of the isolated bacteria was done by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) using the MALDI Biotyper (Bruker). Ceftolozane/tazobactam susceptibility of the isolates was assessed using antimicrobial gradient strips (E-test, BioMérieux). Antimicrobial susceptibility testing and interpretation of the results was done according to the current recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST).ResultsIn total, 281 rectal swabs and 116 urine samples were tested for the presence of Gram-negative rods producing ESBL, and 531 rectal swabs and 8 bronchoalveolar lavage fluid samples were tested for the presence of Gram-negative rods resistant to carbapenems. In the analyzed period, 69 non-repetitive strains of bacteria were isolated that were in the spectrum of activity of ceftolozane/tazobactam. Among 44 clinical strains of ESBL(+) Enterobacteriaceae rods, 76% were susceptible to ceftolozane/tazobactam. All 9 strains of non-carbapenemase-producing P. aeruginosa resistant or with decreased susceptibility to carbapenems were susceptible to ceftolozane/tazobactam.ConclusionsCeftolozane/tazobactam may be an option in the therapy of infections caused by ESBL(+) strains of Enterobacteriaceae as well as non-carbapenemase-producing carbapenem-resistant strains of P. aeruginosa.
Yeast-like fungi of the genus <i>Candida</i>, most often <i>C. albicans</i>, are usually a part of the physiological microflora of humans, however in
immunocompromised individuals may cause invasive infections. At present species other than <i>C. albicans</i> are increasingly reported,
but therapy of these infections is difficult because these fungi are more resistant to antifungals.
<i>Candida auris</i> is a newly described species of yeast-like fungi of the genus <i>Candida</i>, causing infections in hospitalised patients – predominantly fungaemias, sometimes with severe course. This form of infection is linked to a high mortality of patients – from 30 to 72%.
This species has also the ability of epidemic spread in healthcare facilities.
Treatment of infections caused by C. auris poses a therapeutic challenge, as almost all strains of this species are resistant to fluconazole.
It may also be linked to cross-resistance to other azoles. Importantly, many isolates of <i>C. auris</i> are resistant to amphotericin B, and strains
resistant to echinocandins (which are at present recommended as first line therapy of these infections) have also been described.
Currently there are no recommendations as to the combined therapy of infections of this etiology. New antifungal agents potentially
active against <i>C. auris</i> are under development.
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