Activity of Meropenem-Vaborbactam against Bacterial Isolates Causing Pneumonia in Patients in U.S. Hospitals during 2014 to 2018

Abstract

Meropenem-vaborbactam is approved to treat hospital-acquired pneumonia (HAP), including ventilator-associated pneumonia (VAP), in Europe. Meropenem-vaborbactam activity was evaluated against 3,193 Pseudomonas aeruginosa and 4,790 Enterobacterales isolates causing pneumonia, including VAP, in hospitalized patients in the United States. Susceptibility testing was performed by using the broth microdilution method, and all carbapenem-resistant isolates were submitted for whole-genome sequencing. Meropenem-vaborbactam exhibited almost complete activity against Enterobacterales (>99.9% susceptible), including carbapenem-resistant Enterobacterales (CRE), and was also very active against P. aeruginosa isolates (89.5% susceptible).

Activity of meropenem/vaborbactam and comparators against Gram-negative isolates from Eastern and Western European patients hospitalized with pneumonia including ventilator-associated pneumonia (2014–19)

“… 16 , 17 Recently, a similar study was published on meropenem/vaborbactam tested against pneumonia isolates from US patients. 9 The meropenem/vaborbactam susceptibility of US isolates was comparable to that of Western European isolates, reflecting the prevalence of KPC as the primary carbapenemase in these regions.…”

“…A total of 10 413 Gram-negative isolates (6846 Enterobacterales and 3567 P. aeruginosa ) were collected from PHP in 42 European hospitals across 21 countries (1–6 hospitals per country) as previously described. 9 Isolates were consecutively collected; one isolate per patient per infection episode was submitted.…”

New β-Lactam–β-Lactamase Inhibitor Combinations

“…In a recently published study assessing the activity of MER-VAB against pneumoniacausing bacteria (3,193 P. aeruginosa and 4,790 Enterobacterales) isolated between 2014 and 2018 from patients in U.S. hospitals, 99.9% of Enterobacterales (including CRE) and 89.5% of P. aeruginosa were susceptible to MER-VAB (182). Evaluating activity against carbapenem-resistant Enterobacterales in an in vitro hollow-fiber model during Ͼ32-h exposure, MER-VAB (2 g/2 g) showed bactericidal activity against K. pneumoniae, E. cloacae, and E. coli strains, MICs were up to 8 mg/liter (183).…”

Present and Future Perspectives on Therapeutic Options for Carbapenemase-Producing Enterobacterales Infections

“…MER/VAB also has a pronounced activity on class A and class C β-lactamases. Recently, MER/ VAB has gained approval from the European Medicines Agency (EMA) to treat cUTI, acute pyelonephritis, cIAIs, HAP, VAP, and other infections caused by aerobic Gram-negative pathogens in adults with limited treatment options [ 130 ]. Although well analyzed in clinical trials, many more studies are needed on the long-term stability of MER/VAB and IMI/REL and on the potential for antimicrobial resistance, as reported in the case of abusive administration of CAZ/AVI [ 265 ].…”

“…The M/V combination’s efficacy and safety were tested in two clinical trials, TANGO I and TANGO II, showing results as good as those of other compounds and antibacterial combinations used in the management of CRE infections [ 128 , 129 ]. Recently, however, M/V has gained approval from the European Medicines Agency (EMA) for the treatment of cUTI, acute pyelonephritis, cIAIs, HAP, VAP, as well as other infections caused by aerobic Gram-negative pathogens in adults with limited treatment options [ 130 ].…”