Evaluation of in Vitro Activity of Ceftazidime/avibactam and Ceftolozane/tazobactam Against MDR Pseudomonas Aeruginosa Isolates from Qatar

Overview

Journal J Antimicrob Chemother

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2019 Sep 11

PMID 31504587

Citations 22

Authors

Mazen A Sid Ahmed

Hamad Abdel Hadi

Abubaker A I Hassan

Sulieman Abu Jarir

Muna A Al-Maslamani

Nahla Omer Eltai

Khalid M Dousa

Andrea M Hujer

Ali A Sultan

Bo Soderquist

Robert A Bonomo

Emad Bashir Ibrahim

Jana Jass

Ali S Omrani

Affiliations

Soon will be listed here.

Abstract

Objectives: To investigate the in vitro activity of ceftazidime/avibactam and ceftolozane/tazobactam against clinical isolates of MDR Pseudomonas aeruginosa from Qatar, as well as the mechanisms of resistance.

Methods: MDR P. aeruginosa isolated between October 2014 and September 2015 from all public hospitals in Qatar were included. The BD PhoenixTM system was used for identification and initial antimicrobial susceptibility testing, while Liofilchem MIC Test Strips (Liofilchem, Roseto degli Abruzzi, Italy) were used for confirmation of ceftazidime/avibactam and ceftolozane/tazobactam susceptibility. Ten ceftazidime/avibactam- and/or ceftolozane/tazobactam-resistant isolates were randomly selected for WGS.

Results: A total of 205 MDR P. aeruginosa isolates were included. Of these, 141 (68.8%) were susceptible to ceftazidime/avibactam, 129 (62.9%) were susceptible to ceftolozane/tazobactam, 121 (59.0%) were susceptible to both and 56 (27.3%) were susceptible to neither. Twenty (9.8%) isolates were susceptible to ceftazidime/avibactam but not to ceftolozane/tazobactam and only 8 (3.9%) were susceptible to ceftolozane/tazobactam but not to ceftazidime/avibactam. Less than 50% of XDR isolates were susceptible to ceftazidime/avibactam or ceftolozane/tazobactam. The 10 sequenced isolates belonged to six different STs and all produced AmpC and OXA enzymes; 5 (50%) produced ESBL and 4 (40%) produced VIM enzymes.

Conclusions: MDR P. aeruginosa susceptibility rates to ceftazidime/avibactam and ceftolozane/tazobactam were higher than those to all existing antipseudomonal agents, except colistin, but were less than 50% in extremely resistant isolates. Non-susceptibility to ceftazidime/avibactam and ceftolozane/tazobactam was largely due to the production of ESBL and VIM enzymes. Ceftazidime/avibactam and ceftolozane/tazobactam are possible options for some patients with MDR P. aeruginosa in Qatar.

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References

Poirel L, Naas T, Guibert M, Chaibi E, Labia R, Nordmann P . Molecular and biochemical characterization of VEB-1, a novel class A extended-spectrum beta-lactamase encoded by an Escherichia coli integron gene. Antimicrob Agents Chemother. 1999; 43(3):573-81. PMC: 89162. DOI: 10.1128/AAC.43.3.573. View

Gellatly S, Hancock R . Pseudomonas aeruginosa: new insights into pathogenesis and host defenses. Pathog Dis. 2013; 67(3):159-73. DOI: 10.1111/2049-632X.12033. View

Jia B, Raphenya A, Alcock B, Waglechner N, Guo P, Tsang K . CARD 2017: expansion and model-centric curation of the comprehensive antibiotic resistance database. Nucleic Acids Res. 2016; 45(D1):D566-D573. PMC: 5210516. DOI: 10.1093/nar/gkw1004. View

Poirel L, Naas T, Nordmann P . Diversity, epidemiology, and genetics of class D beta-lactamases. Antimicrob Agents Chemother. 2009; 54(1):24-38. PMC: 2798486. DOI: 10.1128/AAC.01512-08. View

Farrell D, Flamm R, Sader H, Jones R . Antimicrobial activity of ceftolozane-tazobactam tested against Enterobacteriaceae and Pseudomonas aeruginosa with various resistance patterns isolated in U.S. Hospitals (2011-2012). Antimicrob Agents Chemother. 2013; 57(12):6305-10. PMC: 3837887. DOI: 10.1128/AAC.01802-13. View

Strateva T, Ouzounova-Raykova V, Markova B, Todorova A, Marteva-Proevska Y, Mitov I . Widespread detection of VEB-1-type extended-spectrum beta-lactamases among nosocomial ceftazidime-resistant Pseudomonas aeruginosa isolates in Sofia, Bulgaria. J Chemother. 2007; 19(2):140-5. DOI: 10.1179/joc.2007.19.2.140. View

Poirel L, Rotimi V, Mokaddas E, Karim A, Nordmann P . VEB-1-like extended-spectrum beta-lactamases in Pseudomonas aeruginosa, Kuwait. Emerg Infect Dis. 2001; 7(3):468-70. PMC: 2631808. DOI: 10.3201/eid0703.010322. View

Buehrle D, Shields R, Chen L, Hao B, Press E, Alkrouk A . Evaluation of the In Vitro Activity of Ceftazidime-Avibactam and Ceftolozane-Tazobactam against Meropenem-Resistant Pseudomonas aeruginosa Isolates. Antimicrob Agents Chemother. 2016; 60(5):3227-31. PMC: 4862525. DOI: 10.1128/AAC.02969-15. View

Lodise Jr T, Patel N, Kwa A, Graves J, Furuno J, Graffunder E . Predictors of 30-day mortality among patients with Pseudomonas aeruginosa bloodstream infections: impact of delayed appropriate antibiotic selection. Antimicrob Agents Chemother. 2007; 51(10):3510-5. PMC: 2043259. DOI: 10.1128/AAC.00338-07. View

10.

Alatoom A, Elsayed H, Lawlor K, AbdelWareth L, El-Lababidi R, Cardona L . Comparison of antimicrobial activity between ceftolozane-tazobactam and ceftazidime-avibactam against multidrug-resistant isolates of Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Int J Infect Dis. 2017; 62:39-43. DOI: 10.1016/j.ijid.2017.06.007. View

11.

Berrazeg M, Jeannot K, Enguene V, Broutin I, Loeffert S, Fournier D . Mutations in β-Lactamase AmpC Increase Resistance of Pseudomonas aeruginosa Isolates to Antipseudomonal Cephalosporins. Antimicrob Agents Chemother. 2015; 59(10):6248-55. PMC: 4576058. DOI: 10.1128/AAC.00825-15. View

12.

Haidar G, Philips N, Shields R, Snyder D, Cheng S, Potoski B . Ceftolozane-Tazobactam for the Treatment of Multidrug-Resistant Pseudomonas aeruginosa Infections: Clinical Effectiveness and Evolution of Resistance. Clin Infect Dis. 2017; 65(1):110-120. PMC: 5848332. DOI: 10.1093/cid/cix182. View

13.

Mauldin P, Salgado C, Hansen I, Durup D, Bosso J . Attributable hospital cost and length of stay associated with health care-associated infections caused by antibiotic-resistant gram-negative bacteria. Antimicrob Agents Chemother. 2009; 54(1):109-15. PMC: 2798544. DOI: 10.1128/AAC.01041-09. View

14.

Yezli S, Shibl A, Memish Z . The molecular basis of β-lactamase production in Gram-negative bacteria from Saudi Arabia. J Med Microbiol. 2014; 64(Pt 2):127-136. DOI: 10.1099/jmm.0.077834-0. View

15.

Weiner L, Webb A, Limbago B, Dudeck M, Patel J, Kallen A . Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011-2014. Infect Control Hosp Epidemiol. 2016; 37(11):1288-1301. PMC: 6857725. DOI: 10.1017/ice.2016.174. View

16.

Chen Z, Niu H, Chen G, Li M, Li M, Zhou Y . Prevalence of ESBLs-producing Pseudomonas aeruginosa isolates from different wards in a Chinese teaching hospital. Int J Clin Exp Med. 2016; 8(10):19400-5. PMC: 4694482. View

17.

Morrissey I, Hackel M, Badal R, Bouchillon S, Hawser S, Biedenbach D . A Review of Ten Years of the Study for Monitoring Antimicrobial Resistance Trends (SMART) from 2002 to 2011. Pharmaceuticals (Basel). 2013; 6(11):1335-46. PMC: 3854014. DOI: 10.3390/ph6111335. View

18.

Magiorakos A, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C . Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2011; 18(3):268-81. DOI: 10.1111/j.1469-0691.2011.03570.x. View

19.

de la Rosa J, Nordmann P, Poirel L . ESBLs and resistance to ceftazidime/avibactam and ceftolozane/tazobactam combinations in Escherichia coli and Pseudomonas aeruginosa. J Antimicrob Chemother. 2019; 74(7):1934-1939. DOI: 10.1093/jac/dkz149. View

20.

Davodian E, Sadeghifard N, Ghasemian A, Noorbakhsh S . Presence of blaPER-1 and blaVEB-1 beta-lactamase genes among isolates of Pseudomonas aeruginosa from South West of Iran. J Epidemiol Glob Health. 2016; 6(3):211-3. PMC: 7320475. DOI: 10.1016/j.jegh.2016.02.002. View