Epidemiology and in vitro activity of ceftazidime-avibactam and comparator agents against multidrug-resistant isolates of Enterobacterales and Pseudomonas aeruginosa collected in Latin America as part of the ATLAS surveillance program in 2015‒2020

Wise, Mark G.; Karlowsky, James A.; Luengas, Elkin Lemos; Valdez, Rafael R.; Sahm, Daniel F.

doi:10.1016/j.bjid.2023.102759

Cited by 4 publications

(3 citation statements)

References 13 publications

(35 reference statements)

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“… 75 In Latin America, the prevalence of Enterobacterales with antibiotic resistance increased from 22% in 2015 to 32% in 2020. 76 Additionally, Gram-negative bacteria are responsible for infection in the skin and soft tissue wounds, which is a possible application of nanoparticles. This study will also demonstrate a possible application of nanoparticles and the fact that in vivo studies can be carried out with specifically resistant strains.…”

Section: Resultsmentioning

confidence: 99%

Biological activity of lyophilized chitosan scaffolds with inclusion of chitosan and zinc oxide nanoparticles

Viloria Angarita,

Insuasty,

Rodríguez M.

et al. 2024

RSC Adv.

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Section: Resultsmentioning

confidence: 99%

Biological activity of lyophilized chitosan scaffolds with inclusion of chitosan and zinc oxide nanoparticles

Viloria Angarita,

Insuasty,

Rodríguez M.

et al. 2024

RSC Adv.

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“…aeruginosa isolates, the annual percent susceptibility rates from North America were higher for CZA (96-99.6%) than for isolates from Europe (90.3-93.1%), 25% of the distinct carbapenem-resistant isolates were also CZA-resistant ( Karlowsky et al., 2022a ), however, no data was acquired on prevalence of carbapenemases in these specific isolates. Data from more than 4000 P. aeruginosa isolates collected from six Latin American countries between 2015 and 2020, revealed a CZA susceptibility rate of approximately 86% amongst all isolates ( Wise et al., 2023 ). Although CZA was the most active antimicrobial agent tested against the subset of multidrug-resistant (MDR) P. aeruginosa , their susceptibility was substantially lower with 53.9% in isolates from 2015-2017, dropping to 45.3% in those from 2018-2020, suggesting increased presence of MBLs, against which CZA is inactive ( Wise et al., 2023 ).…”

Section: Discussionmentioning

confidence: 99%

“…Data from more than 4000 P. aeruginosa isolates collected from six Latin American countries between 2015 and 2020, revealed a CZA susceptibility rate of approximately 86% amongst all isolates ( Wise et al., 2023 ). Although CZA was the most active antimicrobial agent tested against the subset of multidrug-resistant (MDR) P. aeruginosa , their susceptibility was substantially lower with 53.9% in isolates from 2015-2017, dropping to 45.3% in those from 2018-2020, suggesting increased presence of MBLs, against which CZA is inactive ( Wise et al., 2023 ).…”

Section: Discussionmentioning

confidence: 99%

Multifactorial resistance mechanisms associated with resistance to ceftazidime-avibactam in clinical Pseudomonas aeruginosa isolates from Switzerland

Flury

Bösch

Gisler

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundIncreasing reports of multidrug resistance (MDR) in clinical Pseudomonas aeruginosa have led to a necessity for new antimicrobials. Ceftazidime-avibactam (CZA) is indicated for use against MDR P. aeruginosa across a broad range of infection types and particularly those that are carbapenem resistant. This study sought to determine the molecular mechanisms of CZA and imipenem (IPM)-resistance in clinical P. aeruginosa isolates obtained from Swiss hospitals.MethodsClinical P. aeruginosa isolates were obtained from inpatients in three hospitals in Switzerland. Susceptibility was determined by either antibiotic disc testing or broth microdilution according to EUCAST methodology. AmpC activity was determined using cloxacillin and efflux activity was determined using phenylalanine-arginine β-naphthylamide, in agar plates. Whole Genome Sequencing was performed on 18 clinical isolates. Sequence types (STs) and resistance genes were ascertained using the Centre for Genomic Epidemiology platform. Genes of interest were extracted from sequenced isolates and compared to reference strain P. aeruginosa PAO1.ResultsSixteen different STs were identified amongst the 18 isolates in this study indicating a high degree of genomic diversity. No carbapenemases were detected but one isolate did harbor the ESBL blaPER-1. Eight isolates were CZA-resistant with MICs ranging from 16-64 mg/L, and the remaining ten isolates had either low/wildtype MICs (n=6; 1-2 mg/L) or elevated, but still susceptible, MICs (n=4; 4-8 mg/L). Ten isolates were IPM-resistant, seven of which had mutations resulting in truncations of OprD, and the remaining nine IPM-susceptible isolates had intact oprD genes. Within CZA-R isolates, and those with reduced susceptibility, mutations resulting in ampC derepression, OprD loss, mexAB overexpression and ESBL (blaPER-1) carriage were observed in various combinations and one harbored a truncation of the PBP4 dacB gene. Within the six isolates with wildtype-resistance levels, five had no mutations that would affect any antimicrobial resistance (AMR) genes of interest when compared to PAO1.ConclusionThis preliminary study highlights that CZA-resistance in P. aeruginosa is multifactorial and could be caused by the interplay between different resistance mechanisms including ESBL carriage, increased efflux, loss of permeability and derepression of its intrinsic ampC.

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Ceftazidime-avibactam combination therapy versus monotherapy for treating carbapenem-resistant gram-negative infection: a systemic review and meta-analysis

Hsu,

Chuang,

Tsai

et al. 2024

Infection

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Epidemiology and in vitro activity of ceftazidime-avibactam and comparator agents against multidrug-resistant isolates of Enterobacterales and Pseudomonas aeruginosa collected in Latin America as part of the ATLAS surveillance program in 2015‒2020

Cited by 4 publications

References 13 publications

Biological activity of lyophilized chitosan scaffolds with inclusion of chitosan and zinc oxide nanoparticles

Biological activity of lyophilized chitosan scaffolds with inclusion of chitosan and zinc oxide nanoparticles

Multifactorial resistance mechanisms associated with resistance to ceftazidime-avibactam in clinical Pseudomonas aeruginosa isolates from Switzerland

Ceftazidime-avibactam combination therapy versus monotherapy for treating carbapenem-resistant gram-negative infection: a systemic review and meta-analysis

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