Development of EUCAST zone diameter breakpoints and quality control criteria for ceftazidime-avibactam 10-4 μg

Koeth, Laura; Matuschek, Erika; Kahlmeter, Gunnar; Stone, Gregory G.

doi:10.1007/s10096-018-3215-9

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…We obtained 30/20 lg discs from the manufacturer (Hardy Diagnostics, Santa Maria, CA, USA) and 10/4 lg discs (Mast Group Ltd, UK) were provided by EUCAST. Testing was performed according to CLSI and interpreted according to CLSI M100-S27 5 and EUCAST 6,7 guidelines, respectively. The Etest and disc diffusion were performed on Mueller-Hinton agar (Remel, Lenexa, KS, USA).…”

Section: Susceptibility Testingmentioning

confidence: 99%

Performance of ceftazidime/avibactam susceptibility testing methods against clinically relevant Gram-negative organisms

Wenzler

Lee

et al. 2018

Journal of Antimicrobial Chemotherapy

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Objectives To ensure the accuracy of susceptibility testing methods for ceftazidime/avibactam. Methods The performances of the Etest (bioMérieux), 30/20 μg disc (Hardy diagnostics) and 10/4 μg disc (Mast Group) were evaluated against the reference broth microdilution (BMD) method for 102 clinically relevant Gram-negative organisms: 69 ceftazidime- and meropenem-resistant Klebsiella pneumoniae and 33 MDR non-K. pneumoniae. Essential and categorical agreement along with major and very major error rates were determined according to CLSI guidelines. Results A total of 78% of isolates were susceptible to ceftazidime/avibactam. None of the three methods met the defined equivalency threshold against all 102 organisms. The Etest performed the best, with categorical agreement of 95% and major errors of 6.3%. Against the 69 ceftazidime- and meropenem-resistant K. pneumoniae, only the Etest and the 10/4 μg disc met the equivalency threshold. None of the three methods met equivalency for the 33 MDR isolates. There were no very major errors observed in any analysis. These results were pooled with those from a previous study of 74 carbapenem-resistant Enterobacteriaceae and data from the ceftazidime/avibactam new drug application to define optimal 30/20 μg disc thresholds using the error-rate bound model-based approaches of the diffusion breakpoint estimation testing software. This analysis identified a susceptibility threshold of ≤19 mm as optimal. Conclusions Our data indicate that the Etest is a suitable alternative to BMD for testing ceftazidime/avibactam against ceftazidime- and meropenem-resistant K. pneumoniae. The 30/20 μg discs overestimate resistance and may lead to the use of treatment regimens that are more toxic and less effective.

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Section: Susceptibility Testingmentioning

confidence: 99%

Performance of ceftazidime/avibactam susceptibility testing methods against clinically relevant Gram-negative organisms

Wenzler

Lee

et al. 2018

Journal of Antimicrobial Chemotherapy

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“…In both methods, 95.2% of the isolates are susceptible to CZA according to the cut-off values [2]. It is thought that the high correlation between both methods will facilitate the phenotypic determination of CZA in vitro sensitivity in showed that the 13 mm cut-off value correlates well with BMD MIC values and the frequency of major error (false detection) for Enterobacterales is 1.6% [28]. However, it is stated that type of microorganism and resistance pattern (MDR, ceftazidime and carbapenem-resistant) may affect the sensitivity of phenotypic methods and resistance can be detected higher than it is with the disc diffusion method [29,30].…”

Section: Discussionmentioning

confidence: 99%

Ceftazidime – Avibactam susceptibility among carbapenem-resistant Enterobacterales in a pilot study in Turkey

Özger

Evren²,

Yıldız

et al. 2021

AMicr

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This study aimed to detect carbapenemase genes and to determine the in vitro susceptibility of Ceftazidime-Avibactam (CZA) in Enterobacterales isolates. Carbapenemase genes were detected by polymerase chain reaction. CZA sensitivity of isolates was evaluated with broth microdilution (BMD) and disk diffusion methods. A total of 318 carbapenem-resistant Enterobacterales isolates were included. Most of the isolates (n = 290, 91.2%) were identified as Klebsiella pneumoniae. The most common carbapenemase type was OXA-48 (n = 82, 27.6%). CZA susceptibility was evaluated in 84 isolates with OXA-48 and KPC carbapenemase activity. Both BMD and disk diffusion methods revealed that 95.2% of the isolates were sensitive to CZA; whereas, 4 (4.76%) isolates were resistant to CZA. Among colistin resistant isolates, 96.5% (n = 80) of them were susceptible to CZA. Our study demonstrated high in vitro efficacy of CZA in Enterobacterales isolates producing OXA-48 carbapenemase. High susceptibility rates against colistin resistant isolates which generally are also pan drug resistant, makes CZA a promising therapeutic choice for difficult-to-treat infections. Due to its high correlation with the BMD, disk diffusion method is a suitable and more practical method in detecting CZA in vitro activity.

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Use of Ceftazidime-avibactam for the Treatment of Extensively drug-resistant or Pan drug-resistant Klebsiella pneumoniae in Neonates and Children <5 Years of Age

Iosifidis

Chorafa

Agakidou

et al. 2019

Pediatric Infectious Disease Journal

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Background: Emergence of extensively drug-resistant (XDR) or pan drug-resistant (PDR) Enterobacteriaceae is a major public threat especially for young patients. Treatment options for these bacteria are extremely limited with no safety data existing for neonates and children. Ceftazidime-avibactam has activity against Gram-negative bacteria producing Klebsiella pneumoniae carbapenemase, but virtually no data exist on its use in neonatal and pediatric patients. Methods: We present a single-center case series of neonates and children <5 years treated with ceftazidime-avibactam for XDR or PDR K. pneumoniae infections until August 2018. Medical records of patients who received ceftazidime-avibactam for at least 2 days (6 doses) were reviewed. Clinical, laboratory and microbiologic data were collected using a prestructured form. Adverse events and clinical/microbiologic responses and 15- and 30-day outcome were assessed. Results: In our case series, 8 patients (median age 53 days, range from 13 days to 4.5 years) received 9 courses of ceftazidime-avibactam at a dose of 62.5 mg/kg q8h for suspected or proven XDR/PDR K. pneumoniae infections including bloodstream infections (8 courses), central nervous system infections (2 courses) and urinary tract infection (1 course). All patients were critically ill and received other antibiotics prior and concomitantly with the administration of ceftazidime-avibactam. There was no treatment discontinuation due to adverse events. Clinical and microbiologic responses occurred in all patients, and no patient died by day 30. Conclusions: Administration of ceftazidime-avibactam appears to be well tolerated and efficacious against in vitro susceptible XDR or PDR Enterobacteriaceae without being associated with significant adverse events.

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Development of EUCAST zone diameter breakpoints and quality control criteria for ceftazidime-avibactam 10-4 μg

Cited by 4 publications

References 7 publications

Performance of ceftazidime/avibactam susceptibility testing methods against clinically relevant Gram-negative organisms

Performance of ceftazidime/avibactam susceptibility testing methods against clinically relevant Gram-negative organisms

Ceftazidime – Avibactam susceptibility among carbapenem-resistant Enterobacterales in a pilot study in Turkey

Use of Ceftazidime-avibactam for the Treatment of Extensively drug-resistant or Pan drug-resistant Klebsiella pneumoniae in Neonates and Children <5 Years of Age

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