In Vitro
Activity of New β-Lactam–β-Lactamase Inhibitor Combinations and Comparators against Clinical Isolates of Gram-Negative Bacilli: Results from the China Antimicrobial Surveillance Network (CHINET) in 2019
Abstract:Enterobacterales
,
Pseudomonas aeruginosa
, and
Acinetobacter baumannii
are the most common Gram-negative bacilli to cause nosocomial infections throughout the world. Due to their large public health and societal implications, carbapenem-resistant
A. baumannii
(CRAB), carbapenem-resistant
P. aeruginosa
(CRPA), and carbapenem-resistant and third-generation-cephalosporin-resistant
Enterobacteri… Show more
“…Some studies have shown similar activity of CAZ/AVI and PB against CR-GNB (in CRE: 97.5% and 90.5% respectively; in CRPA98.2% and 96.9% respectively and in CRAB 96.6% and 96.6% respectively. 43 On the other hand, a recent meta-analysis suggests that CAZ-AVI treatment the treatment was more efficient thanpolymyxins in CRE. However, in this meta-analysis were included only observational studies with small series of cases.…”
Comparative analysis of mortality of critically ill patients with infections due to carbapenem-resistant Gram-negative bacilli treated with ceftazidime-avibactam or polymyxin B 75
“…Some studies have shown similar activity of CAZ/AVI and PB against CR-GNB (in CRE: 97.5% and 90.5% respectively; in CRPA98.2% and 96.9% respectively and in CRAB 96.6% and 96.6% respectively. 43 On the other hand, a recent meta-analysis suggests that CAZ-AVI treatment the treatment was more efficient thanpolymyxins in CRE. However, in this meta-analysis were included only observational studies with small series of cases.…”
Comparative analysis of mortality of critically ill patients with infections due to carbapenem-resistant Gram-negative bacilli treated with ceftazidime-avibactam or polymyxin B 75
“…The combination was effective against isolates of E. coli, K. pneumoniae , K. oxytoca , and Proteus mirabilis that produced ESBL, AmpC, and CMY-like cephalosporinases. Additionally, the combination has demonstrated efficacy against bacteria containing the genes bla KPC-2 , bla KPC-3 , or bla OXA-48 ( Yahav et al., 2020 ; Guo et al., 2022 ).…”
“…Numerous studies have noted the emergence of CAZ-AVI resistance following exposure, i.e., as a result of increased ceftazidime hydrolysis caused by mutations in the β -loop of K. pneumoniae carbapenemase (KPC) enzymes that are only partially inhibited by avibactam ( Zhanel et al., 2018 ; Guo et al., 2022 ; Hernández-García et al., 2022 ).…”
“…The two most prevalent nucleotidyl transferases in E. coli strains, ANT (2′′) and ANT (3′′, encoded by the aadB and aadA genes, respectively, and are frequently linked to integrons ( Urban-Chmiel et al., 2022 ). The APH (6)-Ia and APH (6)-Id, which are encoded by the strA and strB genes, respectively, are present in all strains of E. coli ( Guo et al., 2022 ).…”
The dissemination of antibiotic resistance in Escherichia coli poses a significant threat to public health worldwide. This review provides a comprehensive update on the diverse mechanisms employed by E. coli in developing resistance to antibiotics. We primarily focus on pathotypes of E. coli (e.g., uropathogenic E. coli) and investigate the genetic determinants and molecular pathways that confer resistance, shedding light on both well-characterized and recently discovered mechanisms. The most prevalent mechanism continues to be the acquisition of resistance genes through horizontal gene transfer, facilitated by mobile genetic elements such as plasmids and transposons. We discuss the role of extended-spectrum β-lactamases (ESBLs) and carbapenemases in conferring resistance to β-lactam antibiotics, which remain vital in clinical practice. The review covers the key resistant mechanisms, including: 1) Efflux pumps and porin mutations that mediate resistance to a broad spectrum of antibiotics, including fluoroquinolones and aminoglycosides; 2) adaptive strategies employed by E. coli, including biofilm formation, persister cell formation, and the activation of stress response systems, to withstand antibiotic pressure; and 3) the role of regulatory systems in coordinating resistance mechanisms, providing insights into potential targets for therapeutic interventions. Understanding the intricate network of antibiotic resistance mechanisms in E. coli is crucial for the development of effective strategies to combat this growing public health crisis. By clarifying these mechanisms, we aim to pave the way for the design of innovative therapeutic approaches and the implementation of prudent antibiotic stewardship practices to preserve the efficacy of current antibiotics and ensure a sustainable future for healthcare.
“…In another study, 86.1% of the CRE strains and 89.8% of CR- K. pneumoniae isolates were inhibited by CEFI/ZIDE at 2 mg/L [ 128 ]. In contrast, most CRE and CR- P. aeruginosa isolates were susceptible to CEFI/ZIDE [ 129 ]. At MICs ≤ 8 mg/L, only 34% of CR- A. baumanii isolates were sensitive to CEFI/ZIDE [ 130 ].…”
Section: Antimicrobials In Phase 3 Clinical Trialsmentioning
Gram-negative bacterial resistance to antimicrobials has had an exponential increase at a global level during the last decades and represent an everyday challenge, especially for the hospital practice of our era. Concerted efforts from the researchers and the industry have recently provided several novel promising antimicrobials, resilient to various bacterial resistance mechanisms. There are new antimicrobials that became commercially available during the last five years, namely, cefiderocol, imipenem-cilastatin-relebactam, eravacycline, omadacycline, and plazomicin. Furthermore, other agents are in advanced development, having reached phase 3 clinical trials, namely, aztreonam-avibactam, cefepime-enmetazobactam, cefepime-taniborbactam, cefepime-zidebactam, sulopenem, tebipenem, and benapenem. In this present review, we critically discuss the characteristics of the above-mentioned antimicrobials, their pharmacokinetic/pharmacodynamic properties and the current clinical data.
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