Race for Life: Antibiotic Selection in Nosocomial Pneumonia

Tetz, George; Vecherkovskaya, Maria; Kardava, K; Tetz, Victor

doi:10.1016/j.chest.2021.12.156

Cited by 3 publications

(3 citation statements)

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“…the approach claims to also consider polymicrobial interactions influencing antimicrobial susceptibility. Case studies have suggested this approach leads to selection of antibiotics with better efficacy for treating nosocomial pneumonia (71) and chronic relapsing urinary tract infections (72). A recently-published clinical trial in which the AtbFinder system was used in the context of respiratory tract infections in CF patients (35 patients, of which 33 were chronically colonized with Pseudomonas aeruginosa) suggests that antibiotics selected with AtbFinder lead to clearance of P.…”

Section: Alternative Methods For Susceptibility Testingmentioning

confidence: 99%

Biofilm antimicrobial susceptibility testing: where are we and where could we be going?

Coenye

2023

Clin Microbiol Rev

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SUMMARY Our knowledge about the fundamental aspects of biofilm biology, including the mechanisms behind the reduced antimicrobial susceptibility of biofilms, has increased drastically over the last decades. However, this knowledge has so far not been translated into major changes in clinical practice. While the biofilm concept is increasingly on the radar of clinical microbiologists, physicians, and healthcare professionals in general, the standardized tools to study biofilms in the clinical microbiology laboratory are still lacking; one area in which this is particularly obvious is that of antimicrobial susceptibility testing (AST). It is generally accepted that the biofilm lifestyle has a tremendous impact on antibiotic susceptibility, yet AST is typically still carried out with planktonic cells. On top of that, the microenvironment at the site of infection is an important driver for microbial physiology and hence susceptibility; but this is poorly reflected in current AST methods. The goal of this review is to provide an overview of the state of the art concerning biofilm AST and highlight the knowledge gaps in this area. Subsequently, potential ways to improve biofilm-based AST will be discussed. Finally, bottlenecks currently preventing the use of biofilm AST in clinical practice, as well as the steps needed to get past these bottlenecks, will be discussed.

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Section: Alternative Methods For Susceptibility Testingmentioning

confidence: 99%

Biofilm antimicrobial susceptibility testing: where are we and where could we be going?

Coenye

2023

Clin Microbiol Rev

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“…The persistence of P. aeruginosa in patients with CF is the result of not only the high antibiotic resistance profile of this pathogen but also the specificity of its behavior in polymicrobial communities that are not accounted for by routine ASTs ( 2 , 14 ). We recently tested the efficacy of AtbFinder, a novel, culture-based test system developed to address the shortcomings of existing ASTs, including the issue of combined antibiotic resistance ( 32 , 33 ).…”

Section: Introductionmentioning

confidence: 99%

AtbFinder Diagnostic Test System Improves Optimal Selection of Antibiotic Therapy in Persons with Cystic Fibrosis

Tetz¹,

Kardava²,

Vecherkovskaya³

et al. 2023

J Clin Microbiol

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“…The persistence of P. aeruginosa in patients with CF is the result of not only the high antibiotic resistance profile of this pathogen, but also the specificity of its behavior in polymicrobial communities that are not accounted for by routine ASTs (2,10). We recently tested the efficacy of AtbFinder, a novel, culture-based test system developed to address the shortcomings of existing ASTs, including the issue of combined antibiotic resistance (39,40).…”

Section: Introductionmentioning

confidence: 99%

AtbFinder Diagnostic Test System Improves Optimal Selection of Antibiotic Therapy in Persons with Cystic Fibrosis

Tetz¹,

Kardava²,

Vecherkovskaya³

et al. 2022

Preprint

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Cystic fibrosis (CF) is characterized by mutations of CFTR that lead to increased viscous secretions, bacterial colonization and recurrent infections. Chronic P. aeruginosa infection in persons with CF is associated with progressive and accelerated lung function decline despite aggressive antibiotic treatment. We report the management of respiratory infections in persons with CF with antibiotic therapy that was based on the recommendations of AtbFinder, a novel, rapid, culture-based diagnostic test system that employs a novel paradigm of antibiotic selection. AtbFinder mimics bacterial interactions with antibiotics at concentrations that can be achieved in affected tissues or organs, and models conditions of interbacterial interactions within polymicrobial biofilms. This open-label, single-arm, investigator‐initiated clinical study was designed to identify the efficacy of antibiotics selected using AtbFinder in persons with CF. Microbiological and clinical parameters were assessed following the change of antibiotic therapy to antibiotics selected with AtbFinder between January 2016 and December 2018 and retrospectively compared with clinical data collected between January 2013 and December 2015.We enrolled 35 persons with CF (33 with chronic P. aeruginosa colonization). Antibiotics selected using AtbFinder resulted in clearance of P. aeruginosa in 81.8% of subsequent cultures, decreased pulmonary exacerbations from 1.21 per patient per annum to 0, and an increase in predicted FEV1% up to 28.4% from baseline. The number of systemic antibiotic courses used in patients after switching to the AtbFinder selected therapy was reduced from 355 to 178. These findings describe the superiority of antibiotic regimens selected with AtbFinder compared with routine antimicrobial susceptibility testing.

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Race for Life: Antibiotic Selection in Nosocomial Pneumonia

Cited by 3 publications

References 0 publications

Biofilm antimicrobial susceptibility testing: where are we and where could we be going?

Biofilm antimicrobial susceptibility testing: where are we and where could we be going?

AtbFinder Diagnostic Test System Improves Optimal Selection of Antibiotic Therapy in Persons with Cystic Fibrosis

AtbFinder Diagnostic Test System Improves Optimal Selection of Antibiotic Therapy in Persons with Cystic Fibrosis

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