&lt;p&gt;Antimicrobial activities of ceftazidime&amp;ndash;avibactam, ceftolozane&amp;ndash;tazobactam, and other agents against &lt;em&gt;Escherichia coli&lt;/em&gt;, &lt;em&gt;Klebsiella pneumoniae&lt;/em&gt;, and &lt;em&gt;Pseudomonas aeruginosa&lt;/em&gt; isolated from intensive care units in Taiwan: results from the Surveillance of Multicenter Antimicrobial Resistance in Taiwan in 2016&lt;/p&gt;

Liao, Chun-Hsing; Lee, Na Yao; Tang, Hung Jen; Lee, Susan Shin Jung; Lin, Ching‐Heng; Lu, Po‐Liang; Wu, Jiunn Jong; Ko, Wen Chien; Lee, Wen Sen; Hsueh, Po-Ren

doi:10.2147/idr.s193638

Cited by 29 publications

(24 citation statements)

References 29 publications

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“…40 Similarly, K. pneumoniae (91%) and P. aeruginosa (66%) were the commonest carbapenemase producing organisms in Taiwan. 45 …”

Section: Discussionmentioning

confidence: 99%

“…40 Similarly, K. pneumoniae (91%) and P. aeruginosa (66%) were the commonest carbapenemase producing organisms in Taiwan. 45 The burden of beta-lactamase producing bacterial infections among ICU patients is aggravated by the high percentage (81.5%) of multi-drug resistant strains. The prevailing prevalence of MDR is in accord with studies done in Uganda (58%), 6 India (72.5%), 26 Nepal (62.1% and 79%) 30,46 and Mexico (70.96%).…”

Section: Discussionmentioning

confidence: 99%

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Extended-Spectrum β-Lactamase and Carbapenemase Producing Gram-Negative Bacilli Infections Among Patients in Intensive Care Units of Felegehiwot Referral Hospital: A Prospective Cross-Sectional Study

Alebel¹,

Mekonnen

Mulu

2021

IDR

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Background Owing to the specific risk profile of its residents, intensive care units (ICUs) are the best place for selection pressure and the epicenter for resistance development and dissemination. Infections with β-lactamase releasing Gram-negative bacilli (GNB) at ICUs are an emerging global threat. This study dogged the magnitude of extended-spectrum β-lactamase (ESBL) and carbapenemase releasing Gram-negative bacilli infections and associated factors among patients in the ICUs of Felegehiwot Referral Hospital, Ethiopia. Methods A cross-sectional study was done through February to June 2020. Wound swabs, urine, blood and sputum samples were collected from patients in the ICUs symptomatic for infections while excluding those under coma and shock. Bacterial species were verified using standard microbiological methods. Carbapenemase and ESBL production were identified using modified carbapenem inactivation and combined disk diffusion methods, respectively. Multivariable analysis was calculated for factors associated with ESBL production. P-value < 0.05 was taken as cut-off for statistical significance. Results Out of 270 patients in the ICU, 67 (24.8%) and 14 (5.2%) had infections with ESBL and carbapenemase releasing GNB, respectively. The most frequent ESBL producing isolates were P. aeruginosa (100%), E. cloacae (100%), K. pneumoniae (82.8%) and E. coli (64%). The predominant carbapenemase producer isolates were K. pneumoniae (27.6%) and E. cloacae (33.3%). Overall, 77 (81.1%) of species were multi-drug resistant. All GNB species were 100% resistant to tetracycline and ampicillin. They are also resistant to cefuroxime, ceftazidime, sulfamethoxazole-trimethoprim and cefotaxime. Prior hospitalization (AOR = 5.5, CI = 2.63–11.46), support with medical care devices (AOR = 23.7, CI = 4.6–12) and arterial intravenous catheterization (AOR = 2.7, CI = 1.3–5.3) had significant association with β-lactamase producing GNB infection. Conclusion Infection with ESBL and carbapenemase producing Gram-negative bacilli linked with an alarming degree of multi-drug resistant isolates is a major healthcare threat among patients in ICUs. Hence, strict adherence to infection prevention practices and wise use of antibiotics are recommended to slow the spread of antimicrobial resistance.

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“…40 Similarly, K. pneumoniae (91%) and P. aeruginosa (66%) were the commonest carbapenemase producing organisms in Taiwan. 45 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Extended-Spectrum β-Lactamase and Carbapenemase Producing Gram-Negative Bacilli Infections Among Patients in Intensive Care Units of Felegehiwot Referral Hospital: A Prospective Cross-Sectional Study

Alebel¹,

Mekonnen

Mulu

2021

IDR

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“…Similar trends were observed among K. pneumoniae isolates, although there were relatively low isolate numbers in the resistant subsets for this species. Studies of antimicrobial resistance in South Korea and Taiwan, on isolates collected between 2012 and 2017, have reported the rates of amikacin resistance to be < 10% among E. coli and K. pneumoniae isolates [20][21][22], and among carbapenemnonsusceptible E. coli isolates (Taiwan only) [23].…”

Section: Discussionmentioning

confidence: 99%

In vitro activity of ceftazidime–avibactam and comparators against Gram-negative bacterial isolates collected in the Asia–Pacific region as part of the INFORM program (2015–2017)

Stone

2020

Ann Clin Microbiol Antimicrob

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Background: Antimicrobial resistance among nosocomial Gram-negative pathogens is a cause for concern in the Asia-Pacific region. The aims of this study were to measure the rates of resistance among clinical isolates collected in Asia-Pacific countries, and to determine the in vitro antimicrobial activities of ceftazidime-avibactam and comparators against these isolates. Methods: CLSI broth microdilution methodology was used to determine antimicrobial activity and EUCAST breakpoints version 9.0 were used to determine rates of susceptibility and resistance. Isolates were also screened for the genes encoding extended-spectrum β-lactamases (ESBLs) or carbapenemases (including metallo-β-lactamases [MBLs]). Results: Between 2015 and 2017, this study collected a total of 7051 Enterobacterales isolates and 2032 Pseudomonas aeruginosa isolates from hospitalized patients in Australia, Japan, South Korea, Malaysia, the Philippines, Taiwan, and Thailand. In the Asia-Pacific region, Enterobacterales isolates that were ESBL-positive, carbapenemase-negative (17.9%) were more frequently identified than isolates that were carbapenemase-positive, MBL-negative (0.7%) or carbapenemase-positive, MBL-positive (1.7%). Multidrug-resistant (MDR) isolates of P. aeruginosa were more commonly identified (23.4%) than isolates that were ESBL-positive, carbapenemase-negative (0.4%), or carbapenemasepositive, MBL-negative (0.3%), or carbapenemase-positive, MBL-positive (3.7%). More than 90% of all Enterobacterales isolates, including the ESBL-positive, carbapenemase-negative subset and the carbapenemase-positive, MBL-negative subset, were susceptible to amikacin and ceftazidime-avibactam. Among the carbapenemase-positive, MBL-positive subset of Enterobacterales, susceptibility to the majority of agents was reduced, with the exception of colistin (93.4%). Tigecycline was active against all resistant subsets of the Enterobacterales (MIC 90 , 1-4 mg/L) and among Escherichia coli isolates, > 90% from each resistant subset were susceptible to tigecycline. More than 99% of all P. aeruginosa isolates, including MDR isolates and the carbapenemase-positive, MBL-positive subset, were susceptible to colistin.

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“… 78 In a study of antimicrobial activity against carbapenem-resistant Enterobacterales isolated from ICUs in Taiwan, ceftazidime/avibactam demonstrated susceptibility rates of 99% for E. coli , 100% for K. pneumoniae and 91% for P. aeruginosa. 94 Ceftazidime/avibactam given as monotherapy or in combination with other agents was superior to other treatment regimens, including carbapenem plus aminoglycoside, colistin and other regimens, against carbapenem-resistant K. pneumoniae bacteraemia. 95 In patients with KPC-producing K. pneumoniae infections, ceftazidime/avibactam proved to be a reasonable alternative treatment option to colistin, and was associated with a lower risk of nephrotoxicity.…”

Section: Main Therapies Currently Used For Mdr Gram-negative Bacterial Infectionsmentioning

confidence: 96%

Current and future perspectives in the treatment of multidrug-resistant Gram-negative infections

Bassetti

Garau

2021

Journal of Antimicrobial Chemotherapy

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Microbial resistance is a serious threat to human health worldwide. Among the World Health Organisation’s list of priority resistant bacteria, three are listed as critical—the highest level of concern—and all three are Gram-negative. Gram-negative resistance has spread worldwide via a variety of mechanisms, the most problematic being via AmpC enzymes, extended-spectrum β-lactamases, and carbapenemases. A combination of older drugs, many with high levels of toxicity, and newer agents are being used to combat multidrug resistance, with varying degrees of success. This review discusses the current treatments for multidrug-resistant Gram-negative bacteria, including new agents, older compounds, and new combinations of both, and some new treatment targets that are currently under investigation.

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Cited by 29 publications

References 29 publications

Extended-Spectrum β-Lactamase and Carbapenemase Producing Gram-Negative Bacilli Infections Among Patients in Intensive Care Units of Felegehiwot Referral Hospital: A Prospective Cross-Sectional Study

Extended-Spectrum β-Lactamase and Carbapenemase Producing Gram-Negative Bacilli Infections Among Patients in Intensive Care Units of Felegehiwot Referral Hospital: A Prospective Cross-Sectional Study

In vitro activity of ceftazidime–avibactam and comparators against Gram-negative bacterial isolates collected in the Asia–Pacific region as part of the INFORM program (2015–2017)

Current and future perspectives in the treatment of multidrug-resistant Gram-negative infections

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