Susceptibility to Imipenem/Relebactam of Pseudomonas aeruginosa and Acinetobacter baumannii Isolates from Chinese Intra-Abdominal, Respiratory and Urinary Tract Infections: SMART 2015 to 2018

Abstract

In recent years, less options are available for treating carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Pseudomonas aeruginosa. The present study investigates the susceptibility rates to imipenem/relebactam for the treatment of intraabdominal infections (IAIs), respiratory tract infections (RTIs) and urinary tract infections (UTIs) caused by A. baumannii and P. aeruginosa in China. Patients and Methods: A total of 1886 P. aeruginosa and 1889 A. baumannii isolates were collected in 21 centers (7 regions) as a part of the global SMART surveillance program between 2015 and 2018. Antimicrobial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) recommendations using the broth microdilution methodology at Peking Union Medical College Hospital. Results: For P. aeruginosa, overall susceptibility rates to imipenem/relebactam were 84.2% at a CLSI breakpoint of ≤2 mg/L compared to 55.7% for imipenem. Susceptibility rates of imipenem-non-susceptible P. aeruginosa to imipenem/relebactam were 64.4% and for multidrug-resistance (MDR) P. aeruginosa susceptibility rates were increased from 25.2% for imipenem to 65.8% for imipenem/relebactam. The susceptibilities of imipenem-nonsusceptible and MDR P. aeruginosa strains were similarly restored by imipenem/relebactam in non-ICU and ICU wards. The rate of imipenem-non-susceptibilities A. baumannii isolates was 79.0%, whereas the MDR rate was 81.9%. Relebactam did not change the susceptibilities of imipenem-non susceptible or MDR A. baumannii isolates. Conclusion:Imipenem/relebactam provides a therapy option to treat infections caused by MDR or imipenem-non-susceptible P. aeruginosa but not A. baumannii infections in China.

Activity of imipenem/relebactam and comparators against KPC-producing Klebsiella pneumoniae and imipenem-resistant Pseudomonas aeruginosa

“…Zhang et al analyzed a collection of 835 non-imipenem-susceptible P. aeruginosa isolates from the global SMART surveillance program, and the susceptibility rates to imipenem/relebactam were 64.4%, and the MIC 50 and MIC 90 values were 2/4 mg/L and >32/4 mg/L, respectively. Compared with our data, the susceptibility percentages were very similar, but the MIC 90 value was 2-fold higher [36]. In our study, imipenem/ B).…”

Nomogram Analysis of Clinical Characteristics and Mortality Risk Factor of Non-Fermentative Gram-Negative Bacteria-Induced Post-Neurosurgical Meningitis

“…[11][12][13] In the past decade, however, PNM caused by NFGNB, especially A. baumannii and P. aeruginosa has increased year by year with a concomitant increase in drug resistance. According to one report, the carbapenem resistance rate of A. baumannii in intensive care units can be as high as 60-70%, 14 and therefore the clinical treatment of patients is extremely difficult. With the widespread use of antibiotics, carbapenem-resistant A. baumannii and carbapenem-resistant P. aeruginosa have become huge clinical threats.…”

Global Threat of Carbapenem-Resistant Gram-Negative Bacteria

“…If two in vitro active agents are not available, in vitro synergy studies are valuable in choosing the most appropriate targeted combination scheme ( Piperaki et al., 2019 ). Novel antibiotics, including ceftolozane-tazobactam, imipenem-relebactam, meropenem-vaborbactam, ceftazidime-avibactam, aztreonam-avibactam, cefepime-enmetazobactam, and cefepime-zidebactam, have significantly poor in vitro activity against XDR- A. baumannii complex, while exhibiting excellent in vitro efficacy against CRE or CR- P. aeruginosa ( Biedenbach et al., 2015 ; Livermore et al., 2017 ; Sader et al., 2017a ; Groft et al., 2021 ; Jean et al., 2021 ; Liu et al., 2021 ; Zhang et al., 2021a ). In contrast, cefiderocol, a novel siderophore modified from ceftazidime, exhibited excellent in vitro activity against several carbapenem-NS GNB species, including A. baumannii complex ( Hsueh et al., 2019 ); however, compared to the best available therapy, higher all-cause mortality rates were observed during the early hospitalization course when cefiderocol was administered for the treatment of patients with nosocomial pneumonia and BSI caused by CR- Acinetobacter species ( Bassetti et al., 2021 ).…”