In vitro activity of ceftazidime-avibactam against Enterobacterales and Pseudomonas aeruginosa isolates collected in Latin America as part of the ATLAS global surveillance program, 2017–2019

Karlowsky, James A.; Kazmierczak, Krystyna M.; Valente, Maria Lavínea Novis de Figueiredo; Lemos, Elkin; Baudrit, Monique; Quintana, Alvaro; Irani, Paurus; Stone, Gregory G.; Sahm, Daniel F.

doi:10.1016/j.bjid.2021.101647

Cited by 15 publications

(22 citation statements)

References 27 publications

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“…For example, ceftazidime/avibactam is recommended as an alternative for severe infections due to KPC-producing or OXA-48 producing Enterobacteriaceae for the management of FN in patients with hematological malignancies, despite the lack of well-designed comparative studies [ 33 , 38 ]. The ATLAS global surveillance program from 2017 to 2019 collected information from the Latin American region and reported in vitro susceptibility to ceftazidime/avibactam and colistin in 99.4% and 74.9% in non-metallo-ẞ-lactamase CPE (n = 358), respectively [ 39 ]. In a scenario like Peru, where there is also an emergence of colistin-resistant Klebsiella pneumoniae strains [ 40 ], it is necessary to consider the inclusion of new ẞ-lactam-ẞ-Lactamase Inhibitor combinations or novel agents (e.g., cefiderocol), considering the increase in bone marrow transplant patients (as seen in period 2) [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Adding a Rapid PCR-Based Blood Culture Identification Panel to the Antimicrobial Stewardship Program of Patients with Febrile Neutropenia in a Peruvian Referral Hospital

et al. 2023

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The addition of Biofire® FilmArray® Blood Culture Identification panel 2 (BCID2) to the antimicrobial stewardship program (ASP) could improve outcomes in bloodstream infections (BSI) of patients with febrile neutropenia (FN). A pre- and post-quasi-experimental single-center study was conducted at a reference hospital in Peru. Three groups were considered: patients with BSI before ASP intervention (control group), patients with BSI after ASP intervention (group 1), and patients with BSI after ASP intervention plus BCID2 PCR Panel implementation (group 2). Overall, 93 patients were identified (32 control, 30 group 1, 31 group 2). The median time to effective therapy was significantly shorter in group 2 compared to group 1 and control group, respectively (3.75 vs. 10 h, p = 0.004; 3.75 vs. 19 h, p < 0.001). No significant differences in terms of relapse of bacteremia, in-hospital mortality (all cause), and 30-day-all-cause hospital readmission between the three study periods were found. The appropriateness of empirical antimicrobial use, adding or change, and the following de-escalation or discontinuation was significant when the two intervention periods were compared with the control group (p < 0.001). In addition to the lack of local studies documenting the microbiological profile of FN episodes, adding syndromic panels-based testing could allow for the consolidation of ASP strategies.

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Section: Discussionmentioning

confidence: 99%

Impact of Adding a Rapid PCR-Based Blood Culture Identification Panel to the Antimicrobial Stewardship Program of Patients with Febrile Neutropenia in a Peruvian Referral Hospital

et al. 2023

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“…In recent years, the resistance rate of P. aeruginosa to CAZ/AVI has been relatively stable across continents, with 13.1% in Latin America, 7.7% in Europe, and 7.3% in the Asia Pacific (Karlowsky et al, 2021;K. M. Kazmierczak, de Jonge, et al, 2018b;Ko & Stone, 2020;Lee et al, 2022).…”

Section: Regional Resistance Surveillance Of Enterobacteriaceaementioning

confidence: 99%

“…By 2015–2017, the resistance rate of Enterobacteriaceae to CAZ/AVI in the Asia‐Pacific region increased to 1.9%, and further investigation of the resistance rate of carbapenem nonsusceptible Enterobacteriaceae to CAZ/AVI in different regions showed that Oceania had the highest CAZ/AVI resistance rate of 88.9%, followed by Asia (51.7%), Africa‐Middle East (49.2%), Europe (23.2%), and the lowest resistance rate was found in Latin America (12.5%; Spiliopoulou et al, 2020 ). By 2017–2019, carbapenem nonsusceptible Enterobacteriaceae bacteria in Latin America increased their resistance rate to CAZ/AVI nearly 1‐fold to 25.3% (Karlowsky et al, 2021 ). In addition, global resistance surveillance by the ATLAS project from 2012 to 2016 showed that carbapenem‐resistant Enterobacteriaceae had a resistance rate of 57.7% to CAZ/AVI, followed by CREC with a resistance rate of 27.7% to CAZ/AVI (H. Zhang, Xu, et al, 2020 ).…”

Section: Prevalence Of Caz / Avi ...mentioning

confidence: 99%

“…INFORM resistance surveillance system in 2012–2015 showed the highest resistance rate to CAZ/AVI in Latin America at 12.6%, followed by Europe (7.6%) and the Asia Pacific (7.4%; Karlowsky et al, 2018 , 2019 ; K. M. Kazmierczak, de Jonge, et al, 2018b ). In recent years, the resistance rate of P. aeruginosa to CAZ/AVI has been relatively stable across continents, with 13.1% in Latin America, 7.7% in Europe, and 7.3% in the Asia Pacific (Karlowsky et al, 2021 ; K. M. Kazmierczak, de Jonge, et al, 2018b ; Ko & Stone, 2020 ; Lee et al, 2022 ). Among carbapenemase‐producing P .…”

Section: Prevalence Of Caz / Avi ...mentioning

confidence: 99%

“…pneumoniae was continuously cultured in broth medium with CAZ/AVI concentration of 1/4 mg/L under antibiotic selective pressure. The results showed that amino acid substitution of Asp354Ala of mdrA gene encoding PBP2 eventually increased MIC of CAZ/AVI from 0.25/4 to 8/4 mg/L (Karlowsky et al, 2021 ; Livermore et al, 2018 ).…”

Section: Mechanisms Underlying Resistance To Caz /...mentioning

confidence: 99%

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Molecular mechanisms underlying bacterial resistance to ceftazidime/avibactam

Xiong

Wang

et al. 2022

WIREs Mechanisms of Disease

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Ceftazidime/avibactam (CAZ/AVI), a combination of ceftazidime and a novel β-lactamase inhibitor (avibactam) that has been approved by the U.S. Food and Drug Administration, the European Union, and the National Regulatory Administration in China. CAZ/AVI is used mainly to treat complicated urinary tract infections and complicated intra-abdominal infections in adults, as well as to treat patients infected with Carbapenem-resistant Enterobacteriaceae (CRE) susceptible to CAZ/AVI. However, increased clinical application of CAZ/AVI has resulted in the development of resistant strains. Mechanisms of resistance in most of these strains have been attributed to bla KPC mutations, which lead to amino acid substitutions in β-lactamase and changes in gene expression. Resistance to CAZ/AVI is also associated with reduced expression and loss of outer membrane proteins or overexpression of efflux pumps. In this review, the prevalence of CAZ/AVI-resistance bacteria, resistance mechanisms, and selection of detection methods of CAZ/AVI are demonstrated, aiming to provide scientific evidence for the clinical prevention and treatment of CAZ/AVI resistant strains, and provide guidance for the development of new drugs.

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Assessment of in vitro activity of ceftazidime/avibactam on carbapenemase‐producing Enterobacterales from Iran: An experimental study

Haeili,

Ghaderi Bavil‐Olyaei

2024

Health Science Reports

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Background and AimsThe prevalence of carbapenemase‐producing Enterobacterales (CPE) continues to increase worldwide. Combination of β‐lactam and novel β‐lactamase inhibitors introduce a revolutionary treatment option for CPE. Ceftazidime/avibactam (CAZ/AVB) has been recently developed for treatment of severe infections caused by multidrug‐resistant bacteria. We aimed to evaluate in vitro activity of CAZ/AVB on a collection of 85 ESBL‐producing‐carbapenemase negative and CPE from Iran.MethodsESBL and carbapenemase production was phenotypically confirmed by combined disk test and modified carbapenem inactivation method respectively. The presence of clinically important carbapenemase encoding genes was examined using PCR. Susceptibility of all isolates to CAZ/AVB was determined using discs containing 30 μg ceftazidime +20 μg avibactam (AVB). Minimum inhibitory concentrations (MICs) of CAZ/AVB in 28 CPE (4 Escherichia coli and 24 Klebsiella pneumoniae) was determined by gradient diffusion method using MIC test strips (0.016−256 mg/L ceftazidime +4 mg/L AVB).ResultsAll phenotypically identified ESBL positive‐carbapenemase negative isolates were found to be susceptible to CAZ/AVB. Among the carbapenem resistant isolates, CAZ/AVB showed potent inhibitory activity against all OXA‐48‐like (MIC ranges 0.125/4−0.75/4 mg/L) and KPC positive isolates (MIC ranges <0.016/4−0.19/4 mg/L). However, AVB could not restore the activity of ceftazdime against isolates producing metallo‐β‐lactamases (MLBs) including VIM, NDM (MIC > 256/4 mg/L) and IMP (MIC > 8/4 mg/L).ConclusionOur data highlighted the excellent in vitro performance of CAZ/AVB against ESBL‐producing and CPE suggesting that this combination can efficiently be used as therapeutic option for management of CPE infections particularly in regions with high prevalence of KPC and/or OXA‐48‐like positive but MBL‐negative Enterobacterales.

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In vitro activity of ceftazidime-avibactam against Enterobacterales and Pseudomonas aeruginosa isolates collected in Latin America as part of the ATLAS global surveillance program, 2017–2019

Cited by 15 publications

References 27 publications

Impact of Adding a Rapid PCR-Based Blood Culture Identification Panel to the Antimicrobial Stewardship Program of Patients with Febrile Neutropenia in a Peruvian Referral Hospital

Impact of Adding a Rapid PCR-Based Blood Culture Identification Panel to the Antimicrobial Stewardship Program of Patients with Febrile Neutropenia in a Peruvian Referral Hospital

Molecular mechanisms underlying bacterial resistance to ceftazidime/avibactam

Assessment of in vitro activity of ceftazidime/avibactam on carbapenemase‐producing Enterobacterales from Iran: An experimental study

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