Evaluation of in-vitro susceptibility of ß-lactam-resistant Gram-negative bacilli to ceftazidime-avibactam and ceftolozane-tazobactam from clinical samples of a general hospital in southern Brazil
The spread of carbapenemase- and extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public health threat that limits therapeutic options for hospitalized patients. This study aimed to evaluate the in-vitro susceptibility of β-lactam-resistant GNB to ceftazi...
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| Published in: | Revista da Sociedade Brasileira de Medicina Tropical Vol. 56 |
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2023
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| Abstract | The spread of carbapenemase- and extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public health threat that limits therapeutic options for hospitalized patients. This study aimed to evaluate the in-vitro susceptibility of β-lactam-resistant GNB to ceftazidime-avibactam (C/A) and ceftolozane-tazobactam (C/T), and investigate the molecular determinants of resistance.
Overall, 101 clinical isolates of Enterobacterales and Pseudomonas aeruginosa collected from a general hospital in Brazil were analyzed. Susceptibility to the antimicrobial agents was evaluated using an automated method, and the minimum inhibitory concentrations (MIC50/90) of C/A and C/T were determined using Etest®. The β-lactamase-encoding genes were investigated using polymerase chain reaction.
High susceptibility to C/A and C/T was observed among ESBL-producing Enterobacterales (100% and 97.3% for CLSI and 83.8% for BRCAST, respectively) and carbapenem-resistant P. aeruginosa (92.3% and 87.2%, respectively). Carbapenemase-producing Klebsiella pneumoniae exhibited high resistance to C/T (80%- CLSI or 100%- BRCAST) but high susceptibility to C/A (93.4%). All carbapenem-resistant K. pneumoniae isolates were susceptible to C/A, whereas only one isolate was susceptible to C/T. Both antimicrobials were inactive against metallo-β-lactamase-producing K. pneumoniae isolates. Resistance genes were concomitantly identified in 44 (44.9%) isolates, with bla CTX-M and bla SHV being the most common.
C/A and C/T were active against microorganisms with β-lactam-resistant phenotypes, except when resistance was mediated by metallo-β-lactamases. Most C/A- and C/T-resistant isolates concomitantly carried two or more β-lactamase-encoding genes (62.5% and 77.4%, respectively). |
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| AbstractList | The spread of carbapenemase- and extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public health threat that limits therapeutic options for hospitalized patients. This study aimed to evaluate the in-vitro susceptibility of β-lactam-resistant GNB to ceftazidime-avibactam (C/A) and ceftolozane-tazobactam (C/T), and investigate the molecular determinants of resistance.
Overall, 101 clinical isolates of Enterobacterales and Pseudomonas aeruginosa collected from a general hospital in Brazil were analyzed. Susceptibility to the antimicrobial agents was evaluated using an automated method, and the minimum inhibitory concentrations (MIC50/90) of C/A and C/T were determined using Etest®. The β-lactamase-encoding genes were investigated using polymerase chain reaction.
High susceptibility to C/A and C/T was observed among ESBL-producing Enterobacterales (100% and 97.3% for CLSI and 83.8% for BRCAST, respectively) and carbapenem-resistant P. aeruginosa (92.3% and 87.2%, respectively). Carbapenemase-producing Klebsiella pneumoniae exhibited high resistance to C/T (80%- CLSI or 100%- BRCAST) but high susceptibility to C/A (93.4%). All carbapenem-resistant K. pneumoniae isolates were susceptible to C/A, whereas only one isolate was susceptible to C/T. Both antimicrobials were inactive against metallo-β-lactamase-producing K. pneumoniae isolates. Resistance genes were concomitantly identified in 44 (44.9%) isolates, with bla CTX-M and bla SHV being the most common.
C/A and C/T were active against microorganisms with β-lactam-resistant phenotypes, except when resistance was mediated by metallo-β-lactamases. Most C/A- and C/T-resistant isolates concomitantly carried two or more β-lactamase-encoding genes (62.5% and 77.4%, respectively). BACKGROUNDThe spread of carbapenemase- and extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public health threat that limits therapeutic options for hospitalized patients. This study aimed to evaluate the in-vitro susceptibility of β-lactam-resistant GNB to ceftazidime-avibactam (C/A) and ceftolozane-tazobactam (C/T), and investigate the molecular determinants of resistance. METHODSOverall, 101 clinical isolates of Enterobacterales and Pseudomonas aeruginosa collected from a general hospital in Brazil were analyzed. Susceptibility to the antimicrobial agents was evaluated using an automated method, and the minimum inhibitory concentrations (MIC50/90) of C/A and C/T were determined using Etest®. The β-lactamase-encoding genes were investigated using polymerase chain reaction. RESULTSHigh susceptibility to C/A and C/T was observed among ESBL-producing Enterobacterales (100% and 97.3% for CLSI and 83.8% for BRCAST, respectively) and carbapenem-resistant P. aeruginosa (92.3% and 87.2%, respectively). Carbapenemase-producing Klebsiella pneumoniae exhibited high resistance to C/T (80%- CLSI or 100%- BRCAST) but high susceptibility to C/A (93.4%). All carbapenem-resistant K. pneumoniae isolates were susceptible to C/A, whereas only one isolate was susceptible to C/T. Both antimicrobials were inactive against metallo-β-lactamase-producing K. pneumoniae isolates. Resistance genes were concomitantly identified in 44 (44.9%) isolates, with bla CTX-M and bla SHV being the most common. CONCLUSIONSC/A and C/T were active against microorganisms with β-lactam-resistant phenotypes, except when resistance was mediated by metallo-β-lactamases. Most C/A- and C/T-resistant isolates concomitantly carried two or more β-lactamase-encoding genes (62.5% and 77.4%, respectively). ABSTRACT Background: The spread of carbapenemase- and extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public health threat that limits therapeutic options for hospitalized patients. This study aimed to evaluate the in-vitro susceptibility of β-lactam-resistant GNB to ceftazidime-avibactam (C/A) and ceftolozane-tazobactam (C/T), and investigate the molecular determinants of resistance. Methods: Overall, 101 clinical isolates of Enterobacterales and Pseudomonas aeruginosa collected from a general hospital in Brazil were analyzed. Susceptibility to the antimicrobial agents was evaluated using an automated method, and the minimum inhibitory concentrations (MIC50/90) of C/A and C/T were determined using Etest®. The β-lactamase-encoding genes were investigated using polymerase chain reaction. Results: High susceptibility to C/A and C/T was observed among ESBL-producing Enterobacterales (100% and 97.3% for CLSI and 83.8% for BRCAST, respectively) and carbapenem-resistant P. aeruginosa (92.3% and 87.2%, respectively). Carbapenemase-producing Klebsiella pneumoniae exhibited high resistance to C/T (80%- CLSI or 100%- BRCAST) but high susceptibility to C/A (93.4%). All carbapenem-resistant K. pneumoniae isolates were susceptible to C/A, whereas only one isolate was susceptible to C/T. Both antimicrobials were inactive against metallo-β-lactamase-producing K. pneumoniae isolates. Resistance genes were concomitantly identified in 44 (44.9%) isolates, with bla CTX-M and bla SHV being the most common. Conclusions: C/A and C/T were active against microorganisms with β-lactam-resistant phenotypes, except when resistance was mediated by metallo-β-lactamases. Most C/A- and C/T-resistant isolates concomitantly carried two or more β-lactamase-encoding genes (62.5% and 77.4%, respectively). |
| Author | Hille, Daniela Kobs, Vanessa Cristine Carvalho, Thaisa Noceti Melo, Luiz Henrique Deglmann, Roseneide Campos França, Paulo Henrique Condeixa de |
| AuthorAffiliation | 1 Universidade da Região de Joinville, Joinville, SC, Brasil 2 Dona Helena Hospital, Joinville, SC, Brasil |
| AuthorAffiliation_xml | – name: 2 Dona Helena Hospital, Joinville, SC, Brasil – name: 1 Universidade da Região de Joinville, Joinville, SC, Brasil – name: Universidade da Região de Joinville – name: Dona Helena Hospital |
| Author_xml | – sequence: 1 givenname: Thaisa Noceti orcidid: 0000-0001-6273-7508 surname: Carvalho fullname: Carvalho, Thaisa Noceti organization: Dona Helena Hospital, Joinville, SC, Brasil – sequence: 2 givenname: Vanessa Cristine orcidid: 0000-0001-6346-2278 surname: Kobs fullname: Kobs, Vanessa Cristine organization: Universidade da Região de Joinville, Joinville, SC, Brasil – sequence: 3 givenname: Daniela orcidid: 0000-0003-2356-0054 surname: Hille fullname: Hille, Daniela organization: Universidade da Região de Joinville, Joinville, SC, Brasil – sequence: 4 givenname: Roseneide Campos orcidid: 0000-0001-5636-2703 surname: Deglmann fullname: Deglmann, Roseneide Campos organization: Universidade da Região de Joinville, Joinville, SC, Brasil – sequence: 5 givenname: Luiz Henrique orcidid: 0000-0002-4461-6267 surname: Melo fullname: Melo, Luiz Henrique organization: Dona Helena Hospital, Joinville, SC, Brasil – sequence: 6 givenname: Paulo Henrique Condeixa de orcidid: 0000-0002-1750-9132 surname: França fullname: França, Paulo Henrique Condeixa de organization: Universidade da Região de Joinville, Joinville, SC, Brasil |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36700602$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1007_s11274_024_03994_0 crossref_primary_10_1016_j_diagmicrobio_2024_116235 |
| Cites_doi | 10.1016/j.diagmicrobio.2019.01.012 10.1016/j.ijantimicag.2019.01.010 10.1016/j.bjid.2017.03.008 10.1007/s15010-017-1096-y 10.1186/s13054-016-1320-7 10.1099/00207713-41-2-324 10.1016/j.vetmic.2018.05.017 10.1016/j.diagmicrobio.2018.11.021 10.1590/0037-8682-0002-2016 10.1128/AAC.03042-15 10.1016/j.jgar.2019.12.009 10.3389/fmicb.2020.01365 10.1016/j.cmi.2015.12.002 10.1080/21505594.2016.1222343 10.1016/j.bjid.2020.04.004 10.1111/j.1469-0691.2011.03570.x 10.1038/s41426-018-0033-1 10.1021/acs.jmedchem.7b00215 10.1128/AAC.00160-19 10.1016/j.ijid.2017.06.007 10.1016/j.jgar.2019.05.028 |
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| Keywords | Ceftolozane-tazobactam Gram-negative bacilli Antimicrobial resistance Genetic marker Ceftazidime-avibactam In vitro activity |
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Doyle, TB; Mendes, RE; Sader, HS |
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| Snippet | The spread of carbapenemase- and extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public health threat that limits... BACKGROUNDThe spread of carbapenemase- and extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public health threat... ABSTRACT Background: The spread of carbapenemase- and extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public... |
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| Title | Evaluation of in-vitro susceptibility of ß-lactam-resistant Gram-negative bacilli to ceftazidime-avibactam and ceftolozane-tazobactam from clinical samples of a general hospital in southern Brazil |
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