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Neves CS, Moura LCRV, Da Costa Lima JL, Maciel MAV. Clinical outcomes of intensive care unit patients infected with multidrug-resistant gram-negative bacteria treated with ceftazidime/avibactam and ceftolozane/tazobactam. Braz J Microbiol 2024; 55:333-341. [PMID: 38133795 PMCID: PMC10920575 DOI: 10.1007/s42770-023-01193-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/17/2023] [Indexed: 12/23/2023] Open
Abstract
In intensive care units (ICUs), infection rates range from 18 to 54%, which is five to ten times higher than those observed in other hospital units, with a mortality rate of 9% to 60%. In recent decades, the susceptibility pattern has changed and Gram-Negative Bacteria (GNB) have become a threat due to their high frequency of multidrug resistance associated with a scarcity of therapeutic options. However, the drugs Ceftolozane/Tazobactam (C/T) and Ceftazidime/Avibactam (C/A) are demonstrating good clinical and microbiological response in the treatment of severe nosocomial infections. Therefore, this study aims to evaluate the clinical outcome of patients with severe infections caused by Multidrug-Resistant (MDR) GNB treated with C/T and C/A. Our study evaluates a total of 131 patients who received treatment with C/T and C/A due to infections caused by MDR GNB within the period from 2018 to 2021. The main infections were urinary tract (46,6%) and respiratory (26,7%) infections. Pseudomonas aeruginosa was the prevailing agent in the sample evaluation (34.3%), followed by Klebsiella pneumoniae (30,1%). About 54,9% of patients showed a favorable response, with culture negativation in 66,4% of the samples, with no discrepancy in negativations when comparing ages: 67,7% in young and 66% in elderly patients. Among the patients, 62,6% received monotherapy with C/T and C/A with a better response observed with monotherapy compared to combination therapy (58,6% vs 41,4%). The overall mortality rate was 45%, with MDR GNB infections responsible for 33,9% of these deaths, and the others (66,1%) due to factors such as oncological, hematological, and degenerative neurological diseases. In regards to hematological aspect, 35,1% of patients showed changes, with 28,2% of them presenting anemia, 4,5% thrombocytopenia, and 2,5% thrombocytosis. Concerning the use of invasive devices, higher mortality was observed in patients on mechanical ventilation (52%). In this manner, it was possible to observe that therapy with C/T and C/A yielded a favorable clinical outcome in patients with severe infections caused by MDR GNB in the study. These drugs also demonstrated good tolerability regardless of age or the presence of preexisting comorbidities and were deemed safe when assessing adverse effects. Our data also demonstrate the importance of determining the mechanism of resistance to carbapenems so that these drugs can be used more effectively and rationally.
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Muteeb G. Network meta-analysis of antibiotic resistance patterns in gram-negative bacterial infections: a comparative study of carbapenems, fluoroquinolones, and aminoglycosides. Front Microbiol 2023; 14:1304011. [PMID: 38098660 PMCID: PMC10720636 DOI: 10.3389/fmicb.2023.1304011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/02/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Antimicrobial resistance poses a grave global threat, particularly with the emergence of multidrug-resistant gram-negative bacterial infections, which severely limit treatment options. The increasing global threat of antimicrobial resistance demands rigorous investigation, particularly concerning multidrug-resistant gram-negative bacterial infections that present limited therapeutic options. This study employed a network meta-analysis, a powerful tool for comparative effectiveness assessment of diverse antibiotics. The primary aim of this study was to comprehensively evaluate and compare resistance patterns among widely used antibiotic classes, namely carbapenems, fluoroquinolones, and aminoglycosides, for combating gram-negative pathogens. Methods We searched PubMed, Web of Sciences, Scopus, Scholarly, Medline, Embase, and Cochrane databases up to August 27, 2023. Studies showing antibiotic resistance in clinical isolates of Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii exposed to carbapenems, fluoroquinolones, and aminoglycosides were included. This study determined treatment-specific resistance percentages and ranked these treatments based on resistance using a random-effects network meta-analysis technique. To investigate the impact of the study and pathogen features, subgroup and meta-regression analyses were performed. Risk ratios and 95% confidence intervals (CIs) were calculated using a network meta-analysis (NMA) incorporating both direct and indirect evidence. Clinical improvement, cure, microbiological eradication, and death from any cause were the primary outcomes. Nephrotoxicity was a secondary result. Results The analysis included 202 publications and 365,782 gram-negative isolates. The NMA included data from 20 studies and 4,835 patients. Carbapenems had the lowest resistance rates throughout the pathogen spectrum, with resistance percentages of 17.1, 22.4, and 33.5% for Enterobacteriaceae, P. aeruginosa, and A. baumannii, respectively. For the same infections, aminoglycosides showed resistance rates of 28.2, 39.1, and 50.2%, respectively. Fluoroquinolones had the highest resistance rates at 43.1, 57.3, and 65.7%, respectively. Unexpectedly, resistance to all three antibiotic classes has increased over time, with multidrug resistance being the most prevalent. Conclusion This extensive network meta-analysis provides an overview of the patterns of resistance throughout the world and how they are changing. The most effective choice is still carbapenems, but the increasing resistance highlights the critical need for multimodal therapies to protect antibiotic effectiveness against these powerful gram-negative infections.
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Affiliation(s)
- Ghazala Muteeb
- Department of Nursing, College of Applied Medical Science, King Faisal University, Al-Ahsa, Saudi Arabia
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Rosa LLS, Andrade-Júnior FP, Cordeiro LV, Souza HDS, Athayde-Filho PF, Gadelha DDA, Melo DM, Silva DF, Alves DN, Sobreira ALC, Ferreira SRD, Teixeira APC, Farias BKS, Firmino RG, Maia AKHL, Lima EO. Association study between ceftriaxone and a synthetic amide against strains of Pseudomonas aeruginosa. BRAZ J BIOL 2023; 83:e274149. [PMID: 37820207 DOI: 10.1590/1519-6984.274149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/23/2023] [Indexed: 10/13/2023] Open
Abstract
Pseudomonas aeruginosa is a non-lactose fermenting Gram-negative bacteria responsible for causing numerous nosocomial infections. The present research aimed to analyze the anti-Pseudomonas aeruginosa potential of 2-Chloro-N-(4-fluoro-3-nitrophenyl)acetamide (A8). The antibacterial potential of A8 was evaluated from the Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) and Association using the checkerboard method. MIC and MBC values were 512 µg/mL for all P. aeruginosa strains evaluated, demonstrating predominantly bactericidal activity. Furthermore, when A8 was associated with the drug ceftriaxone, pharmacological additivity and indifference were evidenced. In this sense, the synthetic amide was interesting, since it demonstrates the potential to become a possible candidate for an antimicrobial drug.
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Affiliation(s)
- L L S Rosa
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, João Pessoa, PB, Brasil
| | - F P Andrade-Júnior
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, João Pessoa, PB, Brasil
| | - L V Cordeiro
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, João Pessoa, PB, Brasil
| | - H D S Souza
- Universidade Federal da Paraíba - UFPB, Centro de Ciências Exatas e da Natureza, Programa de Pós-graduação em Química, João Pessoa, PB, Brasil
| | - P F Athayde-Filho
- Universidade Federal da Paraíba - UFPB, Centro de Ciências Exatas e da Natureza, Programa de Pós-graduação em Química, João Pessoa, PB, Brasil
| | - D D A Gadelha
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, João Pessoa, PB, Brasil
| | - D M Melo
- Universidade Federal de Campina Grande - UFCG, Hospital Universitário Alcides Carneiro, Campina Grande, PB, Brasil
| | - D F Silva
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, João Pessoa, PB, Brasil
| | - D N Alves
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, João Pessoa, PB, Brasil
| | - A L C Sobreira
- Universidade Federal da Paraíba - UFPB, Programa de Pós-graduação em Desenvolvimento e Inovação Tecnológica em Medicamentos - DITM, João Pessoa, PB, Brasil
| | - S R D Ferreira
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, João Pessoa, PB, Brasil
| | - A P C Teixeira
- Universidade Federal da Paraíba - UFPB, Programa de Pós-graduação em Desenvolvimento e Inovação Tecnológica em Medicamentos - DITM, João Pessoa, PB, Brasil
| | - B K S Farias
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, João Pessoa, PB, Brasil
| | - R G Firmino
- Universidade Estadual da Paraíba - UEPB, Programa de Pós-graduação em Psicologia da Saúde, Campina Grande, PB, Brasil
| | - A K H L Maia
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, João Pessoa, PB, Brasil
| | - E O Lima
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, João Pessoa, PB, Brasil
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Carvalho TN, Kobs VC, Hille D, Deglmann RC, Melo LH, de França PHC. 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. Rev Soc Bras Med Trop 2023; 56:S0037-86822023000100303. [PMID: 36700602 PMCID: PMC9870284 DOI: 10.1590/0037-8682-0277-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023] Open
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).
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Affiliation(s)
- Thaisa Noceti Carvalho
- Universidade da Região de Joinville, Joinville, SC, Brasil., Dona Helena Hospital, Joinville, SC, Brasil
| | | | - Daniela Hille
- Universidade da Região de Joinville, Joinville, SC, Brasil
| | | | - Luiz Henrique Melo
- Universidade da Região de Joinville, Joinville, SC, Brasil., Dona Helena Hospital, Joinville, SC, Brasil
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Tuon FF, Dantas LR, Suss PH, Tasca Ribeiro VS. Pathogenesis of the Pseudomonas aeruginosa Biofilm: A Review. Pathogens 2022; 11:pathogens11030300. [PMID: 35335624 PMCID: PMC8950561 DOI: 10.3390/pathogens11030300] [Citation(s) in RCA: 101] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/08/2022] [Accepted: 02/24/2022] [Indexed: 01/21/2023] Open
Abstract
Pseudomonas aeruginosa is associated with several human infections, mainly related to healthcare services. In the hospital, it is associated with resistance to several antibiotics, which poses a great challenge to therapy. However, one of the biggest challenges in treating P. aeruginosa infections is that related to biofilms. The complex structure of the P. aeruginosa biofilm contributes an additional factor to the pathogenicity of this microorganism, leading to therapeutic failure, in addition to escape from the immune system, and generating chronic infections that are difficult to eradicate. In this review, we address several molecular aspects of the pathogenicity of P. aeruginosa biofilms.
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Bahabri NM, Al-Alawi MM, Qutub MO, Tashkandi WA, AlTurki R, Janah SS, Ali HE, Almutairi AF, Khalil S. In-vitro activity of ceftolozane/tazobactam against recent clinical bacterial isolates from two Saudi Arabian hospitals. J Infect Public Health 2022; 15:486-490. [DOI: 10.1016/j.jiph.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 02/15/2022] [Accepted: 02/20/2022] [Indexed: 11/25/2022] Open
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7
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Ito CAS, Bail L, Arend LNVS, Silva KO, Michelotto SS, Nogueira KDS, Tuon FF. Evaluation of MicroScan WalkAway for Determination of Ceftazidime-Avibactam and Ceftolozane-Tazobactam Susceptibility in Carbapenem-Resistant Gram-Negative Bacilli. J Clin Microbiol 2021; 59:e0153621. [PMID: 34586889 PMCID: PMC8601251 DOI: 10.1128/jcm.01536-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/24/2021] [Indexed: 12/27/2022] Open
Abstract
We evaluated the performance of ceftazidime-avibactam and ceftolozane-tazobactam MicroScan Neg multidrug-resistant MIC 1 (NMR1) panel for clinical carbapenem-nonsusceptible Gram-negative bacilli isolates. We evaluated 212 clinically significant carbapenem-nonsusceptible Gram-negative bacilli (139 Pseudomonas aeruginosa and 73 KPC-producing Enterobacterales) from 71 Brazilian hospitals (2013 to 2020). Ceftazidime-avibactam and ceftolozane-tazobactam MICs from the panel were compared with a broth microdilution (BMD) test as the reference method. Essential agreement (EA) and categorical agreement (CA) were assessed. For P. aeruginosa, antimicrobial susceptibility testing error rates were calculated using the error-rate bound method. Discrepancies were initially observed with 11 isolates; 4 resolved after retesting, 2 in favor of the NMR1 and 2 in favor of the BMD method. The ceftazidime-avibactam EA (overall and evaluable) was 100% for P. aeruginosa and Enterobacterales. The CA was 100% for Enterobacterales and 98.6% for P. aeruginosa. The ceftolozane-tazobactam EA was 98.6% and 100% (overall and evaluable, respectively), and the CA was 96.4% for P. aeruginosa. For ceftazidime/avibactam, no very major error (VME) was found, and the major error (ME) rate was 4.2% (2/48). For ceftolozane-tazobactam and P. aeruginosa, using the CLSI breakpoints, the minor error (mE) was 11.4%, and no VME or ME was found. While using EUCAST breakpoints, the VME was 11.4% with no ME. The mE becomes ME or VME in the absence of the intermediate category. All categorical errors were also within 1 log of MIC variation, and the adjusted error rate for CLSI/EUCAST was 0% (0/212). The NMR1 panel is an option to test ceftazidime-avibactam for KPC-producing Enterobacterales and carbapenem-nonsusceptible P. aeruginosa. When a MIC of 4 mg/liter for ceftolozane-tazobactam is obtained using this method, an alert could be created, and the results could be confirmed by an alternative method.
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Affiliation(s)
- Carmen Antonia Sanches Ito
- Division of Microbiology, Universidade Estadual de Ponta Grossa do Paraná, Ponta Grossa, Paraná, Brazil
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Larissa Bail
- Division of Microbiology, Universidade Estadual de Ponta Grossa do Paraná, Ponta Grossa, Paraná, Brazil
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Lavinia Nery Villa Stangler Arend
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
- Laboratório Central do Estado do Paraná–LACEN, Curitiba, Paraná, Brazil
| | | | | | - Keite da Silva Nogueira
- Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
- Basic Pathology Department, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Felipe Francisco Tuon
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
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Wang LT, Lin WT, Lai CC, Wang YH, Chen CH, Chang YT, Chen CH, Wang CY. The safety of ceftolozane-tazobactam for the treatment of acute bacterial infections: a systemic review and meta-analysis. Ther Adv Drug Saf 2021; 12:20420986211027096. [PMID: 34349976 PMCID: PMC8290504 DOI: 10.1177/20420986211027096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/03/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives The aim of this study was to conduct a meta-analysis to assess the clinical safety of ceftolozane-tazobactam for the treatment of acute bacterial infections in adult patients. Methods The PubMed, Embase, and Cochrane databases were searched from their inception until May 2020 for relevant randomized controlled trials (RCTs). Only RCTs evaluating the risk of adverse events (AEs) for ceftolozane-tazobactam and comparative treatments for acute bacterial infections in adult patients were included. Results Overall, four RCTs including a total of 2924 patients (1475 in the ceftolozane-tazobactam group and 1449 in the control group) were included in the meta-analysis. The rate of treatment-emergent AEs was 51.3% (748/1458) in the ceftolozane-tazobactam group, which was comparable to the control group, 49.9% [714/1430; odd's ratio (OR), 1.06; 95% confidence interval (CI), 0.91-1.25; I 2 = 0%]. In addition, no difference was observed between the ceftolozane-tazobactam and control groups in terms of the risk of serious AEs (OR, 1.22; 95% CI, 0.93-1.61; I 2 = 15.5%) and the risk of discontinuing the study drug due to AEs (OR, 0.85; 95% CI, 0.55-1.33; I 2 = 0%). The rate of all-cause mortality did not significantly differ between the ceftolozane-tazobactam and control groups (OR, 1.11; 95% CI, 0.82-1.50; I 2 = 0%). The only exception was the risk of Clostridiodes difficile (C. difficile) colitis, where ceftolozane-tazobactam treatment was associated with a significantly higher risk compared with the control group [0.72% (10/1376) versus 0.14% (2/1391), OR, 3.84; 95% CI, 1.23-11.97; I 2 = 0%]. Conclusion Ceftolozane-tazobactam treatment is as tolerable as comparative treatment options for acute bacterial infections in adult patients, however it has an increased risk of C. difficile infection. As a novel broad-spectrum antibiotic, ceftolozane-tazobactam could be a safe therapeutic option for use in common clinical practice. Plain language summary The safety of ceftolozane-tazobactam (an antibiotics) for the treatment of acute bacterial infections Objective(s): Ceftolozane-tazobactam is an effective antibiotic for the treatment of acute bacterial infections. This study conducts a meta-analysis to assess the clinical safety (side effects) of ceftolozane-tazobactam for the treatment of acute bacterial infections in adult patients compared with other drugs. Methods: We extracted data from four randomized controlled trials, including a total of 2924 patients (1475 in the ceftolozane-tazobactam group and 1449 in the control group). Results: The rate of treatment related adverse events (AEs) was similar in the ceftolozane-tazobactam group (51.3%) and control group (49.9%). There was also no difference in risk of serious adverse events, the risk of discontinuing the study drug due to AEs, and all-cause mortality. The only exception was the risk of Clostridiodes difficile colitis (a cause of antibiotic-associated diarrhea), where ceftolozane-tazobactam treatment was associated with a significantly higher risk compared with the control group. Conclusion: In conclusion, as a novel broad-spectrum antibiotic, ceftolozane-tazobactam could be a safe therapeutic option for use in clinical practice.
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Affiliation(s)
- Li-Ting Wang
- Department of Internal Medicine, Chi-Mei Hospital, Chiali, Tainan
| | - Wei-Ting Lin
- Department of Orthopedic, Chi Mei Medical Center, Tainan
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan
| | - Ya-Hui Wang
- Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City
| | - Cheng-Hsin Chen
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City
| | - Yen-Teh Chang
- Department of Internal Medicine, Cardinal Tien Hospital, No.362, Zhongzheng Road, Xindian Dist., New Taipei City, 231
| | - Chao-Hsien Chen
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, No. 45, Minsheng Rd., Tamsui District, New Taipei City 251
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital, No.362, Zhongzheng Road, Xindian Dist., New Taipei City, 231
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Belkhair J, Nachat S, Rouhi S, Ouassif H, Abbassi S, Soraa N. Evaluation of in vitro activity of ceftolozane-tazobactam in combination with other classes of antibacterial agents against Enterobacterales and Pseudomonas aeruginosa-the EM200 study. New Microbes New Infect 2021; 41:100872. [PMID: 33912351 PMCID: PMC8066805 DOI: 10.1016/j.nmni.2021.100872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/28/2021] [Accepted: 03/12/2021] [Indexed: 11/27/2022] Open
Abstract
Ceftolozane-tazobactam is a cephalosporin/β-lactamase inhibitor combination developed for use against some β-lactam- and multidrug-resistant Gram-negative organisms. This study aimed to evaluate the in vitro activity of ceftolozane-tazobactam against clinical bacterial isolates at the University Hospital of Marrakech. This is a descriptive and analytical prospective study. A total of 143 Enterobacterales and 48 Pseudomonas aeruginosa isolates were collected from January 2018 to December 2018 from patients with respiratory, urinary and intra-abdominal infections. The identification was made by Phoenix automated system (BioMérieux). MIC50/90 were tested by broth microdilution for ceftolozane-tazobactam, and other drugs using dried panels. Antimicrobial susceptibility results were interpreted according to CLSI guidelines. Ceftolozane-tazobactam inhibited 98% of Escherichia coli (MIC50/90; 0.25/0.5 μg/mL). The susceptibility rate of Klebsiella pneumoniae to ceftolozane-tazobactam was 68.8% (MIC50/90, 0.5/>32 μg/mL); other Enterobacterales have shown susceptibility rates of 80.4% (MIC50/90; 0.5/8 μg/mL). In carbapenemase-producing K. pneumoniae, the bla OXA-48 mutation was found in two isolates. Susceptibility of P. aeruginosa to ceftolozane-tazobactam was 91.7% (MIC50/90, 0.5/>32 μg/mL). In non-carbapenemase-producing P. aeruginosa, AmpC mutations were found in all isolates. Ceftolozane-tazobactam was satisfactorily active against a wide range of tested isolates and offers clinicians a potential therapeutic option even against resistant strains in patients with intra-abdominal infections, urinary tract infections and nosocomial pneumonia.
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Affiliation(s)
- J Belkhair
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - S Nachat
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - S Rouhi
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - H Ouassif
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - S Abbassi
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - N Soraa
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
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Ito CAS, Bail L, Arend LNVS, Nogueira KDS, Tuon FF. The activity of ceftazidime/avibactam against carbapenem-resistant Pseudomonas aeruginosa. Infect Dis (Lond) 2021; 53:386-389. [PMID: 33423568 DOI: 10.1080/23744235.2020.1867763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Carmen Antonia Sanches Ito
- Division of Microbiology, Universidade Estadual de Ponta Grossa do Paraná, Paraná, Brazil; Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Larissa Bail
- Division of Microbiology, Universidade Estadual de Ponta Grossa do Paraná, Paraná, Brazil; Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Lavinia Nery Villa Stangler Arend
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil; Laboratório Central do Estado do Paraná - LACEN, Paraná, Brazil
| | - Keite da Silva Nogueira
- Hospital de Clínicas, Universidade Federal do Paraná, Paraná, Brazil; Basic Pathology Department, Universidade Federal do Paraná, Paraná, Brazil
| | - Felipe Francisco Tuon
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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