Synergistic Effect of Ceftazidime-Avibactam with Aztreonam on Carbapenemase-Positive Klebsiella pneumoniae MBL+, NDM+

Szymański, Mateusz; Skiba, Małgorzata; Piasecka, Małgorzata; Olender, Alina

doi:10.2147/idr.s459695

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…The limitation of our study is the single-center nature of the work and the size of the group. 1 This is why it is crucial to publish studies addressing similar issues. However, the study did not include patients with MBL and KPC.…”

Section: Dear Editormentioning

confidence: 99%

Synergistic Effect of Ceftazidime-Avibactam with Aztreonam on Carbapenemase-Positive Klebsiella pneumoniae MBL+, NDM+ [Response to Letter]

Szymański,

Skiba,

Piasecka

2024

IDR

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Section: Dear Editormentioning

confidence: 99%

Synergistic Effect of Ceftazidime-Avibactam with Aztreonam on Carbapenemase-Positive Klebsiella pneumoniae MBL+, NDM+ [Response to Letter]

Szymański,

Skiba,

Piasecka

2024

IDR

Self Cite

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“…While no randomized, well-controlled trials have assessed the safety and efficacy of this combination, observational studies suggest that it is clinically useful in treating serious infections caused by MBL-organisms. 1 We deeply studied and discussed the very informative and clinically useful research entitled “Synergistic Effect of Ceftazidime-Avibactam with Aztreonam on Carbapenemase-Positive Klebsiella pneumoniae MBL+, NDM+” conducted by Mateusz Szymański et al 2 We acknowledge that the research and findings of the author are highly valuable and clinically beneficial.…”

Section: Dear Editormentioning

confidence: 99%

Synergistic Effect of Ceftazidime-Avibactam with Aztreonam on Carbapenemase-Positive Klebsiella pneumoniae MBL+, NDM+ [Letter]

Pathak,

Ghogale

2024

IDR

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Impact of the inoculum size on the in vivo activity of the aztreonam-avibactam combination in a murine model of peritonitis due to Escherichia coli expressing CTX-M-15 and NDM-1

Amoura,

Benchetrit,

Magréault

et al. 2024

Antimicrob Agents Chemother

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The combination of aztreonam (ATM) and avibactam (AVI) is an attractive option to treat infections caused by extended spectrum β-lactamase plus NDM-1-producing Enterobacteriaceae . Since ATM activity was shown to be severely impacted by an increase in the inoculum size in vitro , we wondered whether ATM-AVI activity could be impaired in high-inoculum infections. We analyzed the impact of the inoculum size on ATM-AVI activity in vitro and in a murine model of peritonitis due to susceptible Escherichia coli CFT073-pTOPO and its isogenic derivatives producing NDM-1 ( E. coli CFT073-NDM1) and CTX-M-15 plus NDM-1 ( E. coli CFT073-CTXM15-NDM1). The impact of the inoculum size on bacterial morphology was studied by microscopic examination. In vitro , at standard (10 5 ) inoculum, E. coli CFT073-CTXM15-NDM1 was resistant to ATM but susceptible to the ATM-AVI combination. At high (10 7 ) inoculum, MICs of ATM alone and of the ATM-AVI combination reached >512 and 64 mg/L, respectively, against all tested strains. ATM led to bacterial filamentation when active against the bacteria, i.e., in monotherapy or in combination with AVI against susceptible E. coli CFT073-pTOPO and only in combination with AVI against E. coli CFT073-CTXM15-NDM1. In vivo , increase in the inoculum led to a drastic decrease in the activity of ATM alone against E. coli CFT073-pTOPO and ATM-AVI against E. coli CFT073-CTXM15-NDM1. Our results suggest a high in vivo impact of the inoculum increase on the activity of ATM alone against ATM-susceptible E. coli and of ATM-AVI against CTX-M-15 plus NDM-1 producing E. coli . Clinicians must be aware of the risk of failures when using ATM-AVI in high-inoculum infections.

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Synergistic Effect of Ceftazidime-Avibactam with Aztreonam on Carbapenemase-Positive Klebsiella pneumoniae MBL+, NDM+

Cited by 3 publications

References 17 publications

Synergistic Effect of Ceftazidime-Avibactam with Aztreonam on Carbapenemase-Positive Klebsiella pneumoniae MBL+, NDM+ [Response to Letter]

Synergistic Effect of Ceftazidime-Avibactam with Aztreonam on Carbapenemase-Positive Klebsiella pneumoniae MBL+, NDM+ [Response to Letter]

Synergistic Effect of Ceftazidime-Avibactam with Aztreonam on Carbapenemase-Positive Klebsiella pneumoniae MBL+, NDM+ [Letter]

Impact of the inoculum size on the in vivo activity of the aztreonam-avibactam combination in a murine model of peritonitis due to Escherichia coli expressing CTX-M-15 and NDM-1

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