Actividad de ceftazidima/avibactam en enterobacterias multirresistentes con mecanismos de resistencia combinados

Translated title of the contribution: Activity of ceftazidime–avibactam against multidrug-resistance Enterobacteriaceae expressing combined mechanisms of resistance

Inmaculada López-Hernández*, Noemí Alonso, Marta Fernández-Martínez, Laura Zamorano, Alba Rivera, Antonio Oliver, M. Carmen Conejo, Luis Martínez-Martínez, Ferrán Navarro, Alvaro Pascual

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)

Abstract

Introduction Antimicrobial resistance in Enterobacteriaceae is increasing worldwide and is making treating infections caused by multidrug-resistant Enterobacteriaceae a challenge. The use of β-lactam agents is compromised by microorganisms harboring extended-spectrum β-lactamases (ESBLs) and other mechanisms of resistance. Avibactam is a non β-lactam agent that inhibits clinically relevant β-lactamases, such as ESBL and AmpC. The ceftazidime–avibactam combination (CAZ-AVI) was recently approved for use in certain complicated infections, and may provide a therapeutic alternative for infections caused by these microorganisms. Methods The in vitro activity of CAZ and CAZ-AVI (AVI at a fixed concentration of 4 mg/L) was tested against 250 clinical isolates of Enterobacteriaceae using broth microdilution. EUCAST breakpoint criteria were used for CAZ, and FDA criteria for CAZ-AVI. Clinical isolates included bacteria producing extended-spectrum β-lactamases (ESBLs) and acquired AmpC β-lactamases (AACBLs). Porin loss in Klebsiella pneumoniae was also evaluated. Results The combination of AVI with CAZ displayed excellent activity against clinical isolates of ESBL-producing Escherichia coli and Klebsiella pneumoniae, rendering all the ceftazidime-resistant isolates susceptible to ceftazidime. CAZ-AVI retained activity against porin-deficient isolates of K. pneumoniae producing ESBLs, AACBLs, or both, although MIC values were higher compared to porin-expressing isolates. CAZ-AVI rendered all the ceftazidime-resistant AACBL-producing Enterobacteriaceae tested susceptible to ceftazidime. Conclusion CAZ-AVI showed potent in vitro activity against clinical isolates of Enterobacteriaceae producing ESBLs and/or AACBLs, including K. pneumoniae with loss of porins.

Translated title of the contributionActivity of ceftazidime–avibactam against multidrug-resistance Enterobacteriaceae expressing combined mechanisms of resistance
Original languageSpanish
Pages (from-to)499-504
Number of pages6
JournalEnfermedades Infecciosas y Microbiologia Clinica
Volume35
Issue number8
DOIs
Publication statusPublished - Oct 2017

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