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López-Cerero L, Ballesta S, López CE, Sánchez-Yebra W, Rojo-Martin MD, Pascual A. Evaluation of three commercial methods of susceptibility testing for ceftolozane/tazobactam against carbapenem-resistant Pseudomonas aeruginosa. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:621-624. [PMID: 36737371 DOI: 10.1016/j.eimce.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/23/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Ceftolozane/tazobactam has shown excellent activity against Pseudomonas aeruginosa, but this drug is not always included in commercial panels. The aim of the study was to evaluate the performance of 2 gradient strips (BioMérieux and Liofilchem) and a commercial microdilution panel (Sensititre, EURGNCOL panel) using this combination against carbapenem-resistant P. aeruginosa isolates. METHODS Three commercial methods were tested with 41 metallo-beta-lactamase-producing and 59 non-carbapenemase-producing P. aeruginosa isolates. Broth microdilution was used as reference. RESULTS All carbapenemase-producing isolates and only one non-producing isolate were resistant to this antibiotic. Both essential agreement and bias were outside the acceptance intervals since MIC values were higher than reference values for all three methods. The Kappa index indicated poor or weak agreement. Changes in clinical categories were observed in 3 isolates. CONCLUSIONS The three methods yielded poor agreement with the reference. Despite the differences in MIC values, fewer than 3% involved category changes.
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Affiliation(s)
- Lorena López-Cerero
- Unidad de Gestión Clínica de Microbiología y Enfermedades infecciosas, Hospital Virgen Macarena, Sevilla, Spain; Departamento de Microbiología, Facultad de Medicina de Sevilla, Sevilla, Spain; Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Spain.
| | - Sofia Ballesta
- Departamento de Microbiología, Facultad de Medicina de Sevilla, Sevilla, Spain; Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla, Spain
| | | | - Waldo Sánchez-Yebra
- Servicio de Microbiología, Complejo Hospitalario Torrecárdenas, Almería, Spain
| | | | - Alvaro Pascual
- Unidad de Gestión Clínica de Microbiología y Enfermedades infecciosas, Hospital Virgen Macarena, Sevilla, Spain; Departamento de Microbiología, Facultad de Medicina de Sevilla, Sevilla, Spain; Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Spain
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López-Cerero L, Ballesta S, López CE, Sánchez-Yebra W, Rojo-Martin MD, Pascual A. Evaluation of three commercial methods of susceptibility testing for ceftolozane/tazobactam against carbapenem-resistant Pseudomonas aeruginosa. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Manzke J, Stauf R, Neumann B, Molitor E, Hischebeth G, Simon M, Jantsch J, Rödel J, Becker SL, Halfmann A, Wichelhaus TA, Hogardt M, Serr A, Hess C, Wendel AF, Siegel E, Rohde H, Zimmermann S, Steinmann J. German Multicenter Study Analyzing Antimicrobial Activity of Ceftazidime-Avibactam of Clinical Meropenem-Resistant Pseudomonas aeruginosa Isolates Using a Commercially Available Broth Microdilution Assay. Antibiotics (Basel) 2022; 11:antibiotics11050545. [PMID: 35625189 PMCID: PMC9137722 DOI: 10.3390/antibiotics11050545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/08/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022] Open
Abstract
Multidrug resistance is an emerging healthcare issue, especially concerning Pseudomonas aeruginosa. In this multicenter study, P. aeruginosa isolates with resistance against meropenem detected by routine methods were collected and tested for carbapenemase production and susceptibility against ceftazidime-avibactam. Meropenem-resistant isolates of P. aeruginosa from various clinical materials were collected at 11 tertiary care hospitals in Germany from 2017−2019. Minimum inhibitory concentrations (MICs) were determined via microdilution plates (MICRONAUT-S) of ceftazidime-avibactam and meropenem at each center. Detection of the presence of carbapenemases was performed by PCR or immunochromatography. For meropenem-resistant isolates (n = 448), the MIC range of ceftazidime-avibactam was 0.25−128 mg/L, MIC90 was 128 mg/L and MIC50 was 16 mg/L. According to EUCAST clinical breakpoints, 213 of all meropenem-resistant P. aeruginosa isolates were categorized as susceptible (47.5%) to ceftazidime-avibactam. Metallo-β-lactamases (MBL) could be detected in 122 isolates (27.3%). The MIC range of ceftazidime-avibactam in MBL-positive isolates was 4−128 mg/L, MIC90 was >128 mg/L and MIC50 was 32 mg/L. There was strong variation in the prevalence of MBL-positive isolates among centers. Our in vitro results support ceftazidime-avibactam as a treatment option against infections caused by meropenem-resistant, MBL-negative P. aeruginosa.
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Affiliation(s)
- Jana Manzke
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, 90419 Nuremberg, Germany; (J.M.); (R.S.); (B.N.)
| | - Raphael Stauf
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, 90419 Nuremberg, Germany; (J.M.); (R.S.); (B.N.)
| | - Bernd Neumann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, 90419 Nuremberg, Germany; (J.M.); (R.S.); (B.N.)
| | - Ernst Molitor
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, 53127 Bonn, Germany; (E.M.); (G.H.)
| | - Gunnar Hischebeth
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, 53127 Bonn, Germany; (E.M.); (G.H.)
| | - Michaela Simon
- Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, 93053 Regensburg, Germany; (M.S.); (J.J.)
| | - Jonathan Jantsch
- Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, 93053 Regensburg, Germany; (M.S.); (J.J.)
- Institute for Medical Microbiology, Immunology, and Hygiene, University Hospital Cologne and Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Jürgen Rödel
- Institute of Medical Microbiology, Jena University Hospital, 07743 Jena, Germany;
| | - Sören L. Becker
- Institute of Medical Microbiology and Hygiene, Saarland University, 66421 Homburg, Germany; (S.L.B.); (A.H.)
| | - Alexander Halfmann
- Institute of Medical Microbiology and Hygiene, Saarland University, 66421 Homburg, Germany; (S.L.B.); (A.H.)
| | - Thomas A. Wichelhaus
- German National Consiliary Laboratory on Cystic Fibrosis Bacteriology, Institute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany; (T.A.W.); (M.H.)
| | - Michael Hogardt
- German National Consiliary Laboratory on Cystic Fibrosis Bacteriology, Institute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany; (T.A.W.); (M.H.)
| | - Annerose Serr
- Department for Medical Microbiology and Hygiene, University Hospital Freiburg, 79106 Freiburg, Germany; (A.S.); (C.H.)
| | - Christina Hess
- Department for Medical Microbiology and Hygiene, University Hospital Freiburg, 79106 Freiburg, Germany; (A.S.); (C.H.)
| | - Andreas F. Wendel
- Institute of Hygiene, Cologne Merheim Medical Centre, University Hospital of Witten/Herdecke, 51058 Cologne, Germany;
| | - Ekkehard Siegel
- Institute for Medical Microbiology, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany;
| | - Holger Rohde
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany;
| | - Stefan Zimmermann
- Department of Infectious Diseases, University Hospital Heidelberg, 69120 Heidelberg, Germany;
| | - Jörg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, 90419 Nuremberg, Germany; (J.M.); (R.S.); (B.N.)
- Institute of Medical Microbiology, University Hospital Essen, 45122 Essen, Germany
- Correspondence: ; Tel.: +49-911-398-2520
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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: 91] [Impact Index Per Article: 45.5] [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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