Susceptibility of Gram-negative Pathogens Collected in Israel to Ceftolozane/tazobactam, Imipenem/relebactam and Comparators: SMART 2018-22

Overview

Journal JAC Antimicrob Resist

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2024 Sep 18

PMID 39291180

Authors

Mark G Wise

C Andrew DeRyke

Irina Alekseeva

Fakhar Siddiqui

Katherine Young

Mary R Motyl

Daniel F Sahm

Affiliations

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Abstract

Objectives: To assess the antimicrobial activity of ceftolozane/tazobactam, imipenem/relebactam and comparator agents against clinical isolates of Gram-negative bacilli collected in Israel from 2018 to 2022.

Methods: Six clinical laboratories each collected up to 250 consecutive Gram-negative isolates per year from patients with bloodstream, intra-abdominal, lower respiratory tract and urinary tract infections. MICs were determined by CLSI broth microdilution and interpreted with 2024 EUCAST breakpoints. Acquired β-lactamase gene carriage was investigated for most ceftolozane/tazobactam- and imipenem/relebactam-resistant isolates.

Results: Among the full collection of Enterobacterales (= 4420), 95.1% were susceptible to ceftolozane/tazobactam, including 95.3% of putative AmpC/ESBL-positive, non-carbapenem-resistant Enterobacterales (CRE) phenotype and 86.6% of AmpC/ESBL-positive, non-CRE phenotype . Overall, 99.8% of non- Enterobacterales ( = 3723) were imipenem/relebactam susceptible including 98% of the MDR isolates. Most isolates (= 1182) were inhibited by ceftolozane/tazobactam (93.9% susceptible) and imipenem/relebactam (94.7%). Imipenem/relebactam retained activity against ≥78% of cefepime-resistant, ceftazidime-resistant, and piperacillin/tazobactam-resistant , while ceftolozane/tazobactam inhibited the greatest percentage of meropenem-resistant (67.4%) among comparator β-lactam antimicrobials. Molecular characterization showed the majority of imipenem/relebactam-resistant Enterobacterales harboured a metallo-β-lactamase, while half of the ceftolozane/tazobactam-resistant Enterobacterales carried an acquired ESBL or AmpC. Most of the imipenem/relebactam- and ceftolozane/tazobactam-resistant characterized did not possess acquired β-lactamases.

Conclusions: Recent clinical isolates of Enterobacterales and collected in Israel were highly susceptible to ceftolozane/tazobactam and imipenem/relebactam.

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