Susceptibility of clinical Enterobacterales and Pseudomonas aeruginosa isolates to ceftazidimeavibactam in Russia: multicenter local laboratory databased surveillance

Abstract

Objective. To assess the in vitro activity of ceftazidime-avibactam against clinical Enterobacterales and Pseudomonas aeruginosa isolates in various regions of Russia based on results of local susceptibility testing by disk diffusion method. Materials and Methods. Overall, 160 laboratories located in 61 Russian cities participated in this surveillance during 2018-2020. All consecutive clinical isolates of Enterobacterales and Pseudomonas aeruginosa in each participating laboratory were included in the study. Ceftazidime-avibactam susceptibility testing was done by disc-diffusion method in accordance with current EUCAST recommendations. Susceptibility data for carbapenems and III-IV generation cephalosporins, as well as results of carbapenemases detection, were also reported, if available. All the data were recorded in electronic case report form developed on the OpenClinica online platform (www.openclinica.com). Data analysis and reporting were done using AMRcloud online platform (https://amrcloud.net/). Results. In total, we received information on antimicrobial susceptibility of 22,121 isolates, including 17,456 (78.9%) Enterobacterales and 4,665 (21.1%) P. aeruginosa. Less than 9% of Enterobacterales isolates were resistant to ceftazidime-avibactam. At the same time rates of resistance to ceftazidime, cefotaxime, cefepime, ertapenem, imipenem, and meropenem were 54.1%, 58.9%, 59.4%, 41.4%, 23.9%, and 21.3%. Among Enterobacterales the highest level of resistance to ceftazidime-avibactam was detected in K. pneumoniae (16.5%), lowest – in E. coli (2.1%). Some increase of resistance to ceftazidimeavibactam was noted during the study – from 7.8% in 2018-2019 to 9.6% in 2020 (p = 0.0001). Rate of resistance to ceftazidime-avibactam in P. aeruginosa was 33.1%. At the same time rates of resistance to ceftazidime, cefepime, imipenem, and meropenem were 51.1%, 54.5%, 50%, and 47.3%. During the study there was statistically significant decrease in resistance to ceftazidime-avibactam in P. aeruginosa (p = 0.0001). Resistance rates for all beta-lactams for both Enterobacterales and P. aeruginosa were higher in nosocomial isolates than in community-acquired isolates. Conclusions. Ceftazidime-avibactam demonstrated significantly higher in vitro activity against Enterobacterales and P. aeruginosa Russian clinical isolates comparing with commonly used carbapenems and extended spectrum cephalosporins. Access for all study data available at the AMRcloud online platform (https://amrcloud.net/ru/project/cazavi-1-2/).

Point prevalence multicenter survey of antimicrobial consumption in Russian hospitals: results of the Global-PPS 2021

“…Так, по результатам исследования, выполнен ного за период с 2018 по 2020 г. и включавшего 22121 грамотрицательный изолят (78,9% Enterobacterales и 21,1% Pseudomonas aeruginosa), распространенность устойчивости представителей Enterobacterales к цефта зидиму, цефотаксиму, цефепиму, эртапенему, имипенему и меропенему составила 54,1%, 58,9%, 59,4%, 41,4%, 23,9% и 21,3%, P. аeruginosa к цефтазидиму, цефепиму, имипенему и меропенему -51,1%, 54,5%, 50% и 47,3% соответственно. Резистентность ко всем беталактамам была значимо выше среди нозокомиальных штаммов по сравнению с внебольничными [4]. При этом, по данным российского многоцентрового эпидемиологического ис следования «ЭРГИНИ», оценочная частота развития но зокомиальных инфекций в Российской Федерации со ставляет около 2,3 млн случаев в год [5].…”

“…В.Ф. ВойноЯсенецкого» Минздрава России, Красноярск, Россия 4 БУЗОО «Областная клиническая больница», Омск, Россия 5 ФГБУ «Национальный медицинский исследовательский центр сердечнососудистой хирургии им. А.Н.…”