Ceftazidime-avibactam, meropenen-vaborbactam, and imipenem-relebactam in combination with aztreonam against multidrug-resistant, metallo-β-lactamase-producing Klebsiella pneumoniae
- 17 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Clinical Microbiology & Infectious Diseases
- Vol. 40 (8), 1755-1759
- https://doi.org/10.1007/s10096-021-04197-3
Abstract
The spread of multidrug-resistant (MDR), metallo-β-lactamase (MBL)-producing Klebsiella pneumoniae represents a major therapeutic challenge. The newly introduced β-lactam-β-lactamase inhibitors (BLBLIs), ceftazidime/avibactam (CAZ/AVI), meropenem/vaborbactam (M/V), and imipenem/relebactam (I/R) are inactive against MBLs. The aim of this study was to evaluate the in vitro efficacy of aztreonam (ATM) in combination with CAZ/AVI, M/V, and I/R against 40 MDR, MBL-producing, and serine-β-lactamases co-producing Klebsiella pneumoniae using the Etest method. Synergy was defined as a fractional inhibitory concentration index ≤0.5. All isolates were resistant to ATM, CAZ/AVI, and I/R and 38/40 (95%) were resistant to M/V. Synergy was observed in 97.5% in the combinations CAZ/AVI-ATM, and I/R-ATM and in 72.5% in the combination M/V-ATM. Further clinical studies are required to confirm the efficacy of these antimicrobial combinations.Keywords
This publication has 30 references indexed in Scilit:
- In Vitro Discordance with In Vivo Activity: Humanized Exposures of Ceftazidime-Avibactam, Aztreonam, and Tigecycline Alone and in Combination against New Delhi Metallo-β-Lactamase-Producing Klebsiella pneumoniae in a Murine Lung Infection ModelAntimicrobial Agents and Chemotherapy, 2017
- Tigecycline resistance among carbapenem-resistant Klebsiella Pneumoniae: Clinical characteristics and expression levels of efflux pump genesPLOS ONE, 2017
- Can Ceftazidime-Avibactam and Aztreonam Overcome β-Lactam Resistance Conferred by Metallo-β-Lactamases in Enterobacteriaceae?Antimicrobial Agents and Chemotherapy, 2017
- Increased Costs Associated with Bloodstream Infections Caused by Multidrug-Resistant Gram-Negative Bacteria Are Due Primarily to Patients with Hospital-Acquired InfectionsAntimicrobial Agents and Chemotherapy, 2017
- Predictors of mortality in bloodstream infections caused by multidrug-resistant gram-negative bacteria: 4 years of collectionAmerican Journal of Infection Control, 2016
- Spectrum of excess mortality due to carbapenem-resistant Klebsiella pneumoniae infectionsClinical Microbiology & Infection, 2016
- Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemasesThe Lancet Infectious Diseases, 2013
- Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistanceClinical Microbiology & Infection, 2012
- Synergy of fosfomycin with carbapenems, colistin, netilmicin, and tigecycline against multidrug-resistant Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa clinical isolatesEuropean Journal of Clinical Microbiology & Infectious Diseases, 2011
- Multiplex PCR for detection of acquired carbapenemase genesDiagnostic Microbiology and Infectious Disease, 2011