Ceftazidime/Avibactam and Other Commonly Used Antibiotics Activity Against Enterobacterales and Pseudomonas aeruginosa Isolated in Poland in 2015-2019

• Published in: Infection and drug resistance 2022-01, Vol.15, p.1289-1304
• Main Authors: Zalas-Więcek, Patrycja, Prażyńska, Małgorzata, Pojnar, Łukasz, Pałka, Anna, Żabicka, Dorota, Orczykowska-Kotyna, Monika, Polak, Aleksandra, Możejko-Pastewka, Barbara, Głowacka, Ewa Anna, Pieniążek, Izabela, Pawlik, Małgorzata, Grys, Maciej, Bogiel, Monika
• Format: Article
• Language: English
• Subjects: Analysis; Antibacterial agents; Antibiotics; Antimicrobial agents; Bacteria; Beta lactamases; carbapenem resistance; Ceftazidime; ceftazidime/avibactam; Children; Chromium; Colistin; drug resistance; Drug resistance in microorganisms; Drug therapy; E coli; Enterobacterales; esbl; Gram-negative bacteria; gram-negative rods; Health aspects; Infection; Laboratories; mdr; Medical research; Medicine, Experimental; Metallo-β-lactamase; Morbidity; Mortality; Multidrug resistance; Nosocomial infections; Original Research; Patients; Pediatric intensive care; Pediatrics; Phenotypes; Pneumonia; Poland; Pseudomonas aeruginosa; Public health; Strains (organisms); Susceptibility; β Lactamase
• ISSN: 1178-6973; 1178-6973
• DOI: 10.2147/IDR.S344165

Infections caused by resistant Gram-negative bacteria are becoming increasingly common and now pose a serious public health threat worldwide, because they are difficult to treat due to few treatment options and they are associated with high morbidity and mortality. The combination of ceftazidime with the beta-lactamase inhibitor avibactam - seems to be the right choice in this situation. The aim of the study was to evaluate the activity of ceftazidime/avibactam and other commonly used antibiotics against Enterobacterales and strains isolated within last years in Poland. This study analyzed the antibiotic susceptibility of 1607 Enterobacterales isolates and 543 nonfermenting strains collected between 2015 and 2019 in 4 medical laboratories participating in the ATLAS (Antimicrobial Testing Leadership And Surveillance) program in Poland. Unduplicated clinically significant Enterobacterales and strains were collected from patients with respiratory, skin and musculoskeletal, genitourinary, abdominal, bloodstream or other infections (ear, eye). The ceftazidime/avibactam combination demonstrates the highest activity against Enterobacterales (98.9%), in both adults and children, including strains presenting MDR (multidrug-resistant) (97.5%) and ESBL (extended spectrum β-lactamase) (96.3%) phenotypes. The activity of ceftazidime/avibactam increased to 100% when only MBL (metallo-β-lactamase)-negative subset of Enterobacterales was considered. This combination also achieved the second highest activity result (89.3%) after colistin in , including isolates of MDR (65.9%) and carbapenem-resistant (CR) phenotypes (54.8%). When MBL-positive isolates were excluded, susceptibility rate of increased to 94.7%. It is worth to note that susceptibility of the examined strains to ceftazidime/avibactam was very high in children (93.3%), especially in a pediatric intensive care unit (94.2%). Enterobacterales and included in this analysis presented high susceptibility rates to ceftazidime/avibactam. Ceftazidime/avibactam showed the highest activity against Enterobacterales strains among all antibiotics studied, both for the total population as well as for MDR phenotype and ESBL phenotype. Ceftazidime/avibactam also achieved the second highest activity result against strains (including MDR and CR phenotypes). These results are much higher when excluding MBL-positive isolates that exhibit intrinsic resistance to ceftazidime/avibactam.