Activity of ceftolozane/tazobactam against Pseudomonas aeruginosa and Enterobacterales isolates recovered from intensive care unit patients in Spain: The SUPERIOR multicentre study

García‐Fernández, Sergio; García-Castillo, María; Bou, Germán; Calvo, Jorge; Cercenado, Emilia; Delgado, Mercedes; Pitart, Cristina; Mulet, Xavier; Tormo, Nuria; Mendoza, Diego López; Díaz-Regañón, Jazmín; Cantón, Rafael

doi:10.1016/j.ijantimicag.2019.02.004

Cited by 41 publications

(41 citation statements)

References 13 publications

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“…On the other hand, options for MBL-producing K. pneumoniae are limited. The novel β-lactam–β-lactamase inhibitor combinations, including ceftazidime/avibactam [ 59 ], ceftolozane/tazobactam [ 76 ], meropenem/vaborbactam [ 77 ] and imipenem/relebactam [ 55 ], are inactive against MBL-producing GNB [ 78 ]. In contrast, the combination of aztreonam with avibactam may restore activity against MBL-producing isolates [ 60 , 79 ], because aztreonam is not hydrolyzed by MBLs and avibactam effectively inhibits other beta-lactamases (ESBL, KPC and OXA-48) that can hydrolyze aztreonam.…”

Section: Options For Capt-resistant K Pneumoniaementioning

confidence: 99%

“…Neither imipenem/relebactam nor ceftolozane/tazobactam or ceftazidime/avibactam is active against MBL-producing P. aeruginosa [ 55 , 59 , 76 ]. Furthermore, in contrast to MBL-producing K. pneumoniae , aztreonam/avibactam cannot overcome resistance against most MBL-producing P. aeruginosa due to mechanisms of resistance to aztreonam independent of beta-lactamases [ 112 ].…”

Section: Options For Capt-resistant P Aeruginosamentioning

confidence: 99%

See 1 more Smart Citation

Treatment options for K. pneumoniae, P. aeruginosa and A. baumannii co-resistant to carbapenems, aminoglycosides, polymyxins and tigecycline: an approach based on the mechanisms of resistance to carbapenems

2020

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The management of carbapenem-resistant infections is often based on polymyxins, tigecycline, aminoglycosides and their combinations. However, in a recent systematic review, we found that Gram-negative bacteria (GNB) co-resistant to carbapanems, aminoglycosides, polymyxins and tigecycline (CAPT-resistant) are increasingly being reported worldwide. Clinical data to guide the treatment of CAPT-resistant GNB are scarce and based exclusively on few case reports and small case series, but seem to indicate that appropriate (in vitro active) antimicrobial regimens, including newer antibiotics and synergistic combinations, may be associated with lower mortality. In this review, we consolidate the available literature to inform clinicians dealing with CAPT-resistant GNB about treatment options by considering the mechanisms of resistance to carbapenems. In combination with rapid diagnostic methods that allow fast detection of carbapenemase production, the approach proposed in this review may guide a timely and targeted treatment of patients with infections by CAPT-resistant GNB. Specifically, we focus on the three most problematic species, namely Klebsiella pneumoniae , Pseudomonas aeruginosa and Acinetobacter baumannii . Several treatment options are currently available for CAPT-resistant K. pneumonia . Newer β-lactam-β-lactamase combinations, including the combination of ceftazidime/avibactam with aztreonam against metallo-β-lactamase-producing isolates, appear to be more effective compared to combinations of older agents. Options for P. aeruginosa (especially metallo-β-lactamase-producing strains) and A. baumannii remain limited. Synergistic combination of older agents (e.g., polymyxin- or fosfomycin-based synergistic combinations) may represent a last resort option, but their use against CAPT-resistant GNB requires further study.

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Section: Options For Capt-resistant K Pneumoniaementioning

confidence: 99%

Section: Options For Capt-resistant P Aeruginosamentioning

confidence: 99%

Treatment options for K. pneumoniae, P. aeruginosa and A. baumannii co-resistant to carbapenems, aminoglycosides, polymyxins and tigecycline: an approach based on the mechanisms of resistance to carbapenems

2020

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“…On the other hand, options for MBL-producing K. pneumoniae are limited. The novel β-lactam-βlactamase inhibitor combinations, including ceftazidime/avibactam [56], ceftolozane/tazobactam [74], meropenem/vaborbactam [75] and imipenem/relebactam [52], are inactive against MBL-producing GNB [76]. In contrast, the combination of aztreonam with avibactam may restore activity against MBL-producing isolates [57,77], because aztreonam is not hydrolyzed by MBLs and avibactam effectively inhibits other beta-lactamases (ESBL, KPC and OXA-48) that can hydrolyze aztreonam.…”

Section: Brief Overview Of the Mechanisms Of Resistance To Carbapenemsmentioning

confidence: 99%

“…Neither imipenem/relebactam nor ceftolozane/tazobactam or ceftazidime/avibactam are active against MBL-producing P. aeruginosa [52,56,74]. Furthermore, in contrast to MBL-producing K. pneumoniae, aztreonam/avibactam cannot overcome resistance against most MBL-producing P. aeruginosa due to mechanisms of resistance to aztreonam independent of beta-lactamases [108].…”

Section: Options For Cact-resistant P Aeruginosamentioning

confidence: 99%

Treatment Options for K. pneumoniae, P. aeruginosa and A. baumannii Co-resistant to Carbapenems, Aminoglycosides, Colistin and Tigecycline. An Approach Based on the Mechanisms of Resistance to Carbapenems

Karakonstantis¹,

Kritsotakis²,

Gikas³

2020

Preprint

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The management of carbapenem-resistant infections is often based on colistin, tigecycline, aminoglycosides and their combinations. However, in a recent systematic review we found that Gram-negative bacteria (GNB) co-resistant to carbapanems, aminoglycosides, colistin and tigecycline (CACT-resistant) are increasingly being reported worldwide. Clinical data to guide the treatment of CACT-resistant GNB are scarce and based exclusively on few case reports and small case series but seem to indicate that appropriate (in vitro active) antimicrobial regimens, including newer antibiotics and synergistic combinations, may be associated with lower mortality. In this review we consolidate the available literature to inform clinicians dealing with CACT-resistant GNB about treatment options by considering the mechanisms of resistance to carbapenems. In combination with rapid diagnostic methods that allow fast detection of carbapenemase production, the approach proposed in this review may guide a timely and targeted treatment of patients with infections by CACT-resistant GNB. Specifically, we focus on the three most problematic species, namely Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii. Several treatment options are currently available for CACT-resistant K. pneumonia. Newer β-lactam-β-lactamase combinations, including the combination of ceftazidime/avibactam with aztreonam against metallo-β-lactamase-producing isolates, appear to be more effective compared to combinations of older agents. Options for P. aeruginosa (especially metallo-β-lactamase-producing strains) and A. baumannii remain limited. Synergistic combination of older agents (e.g. colistin- or fosfomycin-based synergistic combinations) may represent a last resort option but their use against CACT-resistant GNB requires further study.

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“…6 Unlike avibactam, the studies demonstrated that tazobactam has no ability in inhibiting AmpC β-lactamases and several carbapenemases such as OXA-48, KPC-2, and KPC-3. 7 Recently, ceftazidime-avibactam and ceftolozanetazobactam were approved by the US Food and Drug Administration (FDA) and by the European Medicine Agency (EMA) to treat infections such as complicated urinary tract infections (CUTIs), complicated intra-abdominal infections (CIAIs), and complicated hospital-acquired pneumonia (HAP) in patients with limited treatment options. 8 The present study aimed, for the first time in Iran, to evaluate the efficacy of ceftazidime-avibactam and ceftolozane-tazobactam against P. aeruginosa isolates from patients with UTIs in two Iranian hospitals.…”

Section: Introductionmentioning

confidence: 99%

First Study of Antimicrobial Activity of Ceftazidime-Avibactam and Ceftolozane-Tazobactam Against Pseudomonas aeruginosa Isolated from Patients with Urinary Tract Infection in Tehran, Iran

Rahimzadeh

Habibi

Bouzari

et al. 2020

IDR

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Purpose: Pseudomonas aeruginosa causes complicated and/or nosocomial UTI. These infections are usually associated with severe and multi-drug resistant P. aeruginosa isolates. As there is no study about the activity of novel antibiotics ceftazidime-avibactam (CZA) and ceftolozanetazobactam (C/T) against P. aeruginosa isolates in Iran, we aimed to evaluate for the first time the efficacy of these agents against P. aeruginosa isolated from patients with UTI in Iran. Then, the genetic diversity of the resistant isolates was assayed. Methods: In this study, a total of 200 P. aeruginosa isolates were collected from patients with UTI in Tehran, Iran. Disk diffusion and Minimum Inhibitory Concentration (MIC) methods were applied to determine the resistance of the isolates to CZA, C/T, and the other antibiotics. Extended-spectrum β-lactamases (ESBLs) and Metallo Beta Lactamase (MBL) production were assayed by Combination disk diffusion test (CDDT). Polymerase chain reaction (PCR) was carried out to detect the resistance genes, including beta-lactamases and carbapenemases genes. Finally, genomic analysis of the isolates was performed using the Pulse field gel electrophoresis (PFGE). Results: Among the isolates, 16 (8%) were resistant to CZA and C/T that MIC confirmed it. The resistant isolates showed high resistance to the other classes of antibiotics. Among the resistant isolates, 31.2% and 75% were ESBL and MBL producers, respectively. The prevalence of bla OXA10 , bla VIM , bla OXA48 , bla OXA2 , and bla CTX-M was 100%, 50%, 31.2%, 25%, and 12.5%. Furthermore, two isolates (12.5%) harbored bla PER and bla NDM genes. The resistant isolates were grouped into 14 distinct pulsotypes and two shared pulsotypes were found. Conclusion: Ceftazidime-avibactam and ceftolozane-tazobactam showed high activity against the P. aeruginosa isolated from patients with UTI in Iran. The low rate of resistance to the antibiotics is also alarming and should be considered to avoid further spreading of the antibiotic resistance among the P. aeruginosa and the other bacteria.

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Activity of ceftolozane/tazobactam against Pseudomonas aeruginosa and Enterobacterales isolates recovered from intensive care unit patients in Spain: The SUPERIOR multicentre study

Cited by 41 publications

References 13 publications

Treatment options for K. pneumoniae, P. aeruginosa and A. baumannii co-resistant to carbapenems, aminoglycosides, polymyxins and tigecycline: an approach based on the mechanisms of resistance to carbapenems

Treatment options for K. pneumoniae, P. aeruginosa and A. baumannii co-resistant to carbapenems, aminoglycosides, polymyxins and tigecycline: an approach based on the mechanisms of resistance to carbapenems

Treatment Options for <em>K. pneumoniae</em>, <em>P. aeruginosa</em> and <em>A. baumannii</em> Co-resistant to Carbapenems, Aminoglycosides, Colistin and Tigecycline. An Approach Based on the Mechanisms of Resistance to Carbapenems

<p>First Study of Antimicrobial Activity of Ceftazidime-Avibactam and Ceftolozane-Tazobactam Against <em>Pseudomonas aeruginosa</em> Isolated from Patients with Urinary Tract Infection in Tehran, Iran</p>

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