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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Antimicrob+Agents+Chemother
2015 ; 59
(6
): 3509-17
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Ceftazidime-avibactam activity tested against Enterobacteriaceae isolates from
U S hospitals (2011 to 2013) and characterization of ?-lactamase-producing
strains
#MMPMID25845862
Castanheira M
; Mills JC
; Costello SE
; Jones RN
; Sader HS
Antimicrob Agents Chemother
2015[]; 59
(6
): 3509-17
PMID25845862
show ga
Ceftazidime-avibactam (MIC50/90, 0.12/0.25 ?g/ml) inhibited 99.9% (20,698/20,709)
of Enterobacteriaceae isolates at ?8 ?g/ml. This compound was active against
resistant subsets, including ceftazidime-nonsusceptible Enterobacter cloacae
(MIC50/90, 0.25/0.5 ?g/ml) and extended-spectrum ?-lactamase (ESBL) phenotype
isolates. An ESBL phenotype was noted among 12.4% (1,696/13,692 isolates from
targeted species) of the isolates, including 776 Escherichia coli (12.0% for this
species; MIC50/90, 0.12/0.25 ?g/ml), 721 Klebsiella pneumoniae (16.3%; MIC50/90,
0.12/0.25 ?g/ml), 119 Klebsiella oxytoca (10.3%; MIC50/90, 0.06/0.25 ?g/ml), and
80 Proteus mirabilis (4.9%; MIC50/90, 0.06/0.12 ?g/ml) isolates. The most common
enzymes detected among ESBL phenotype isolates from 2013 (n = 743) screened using
a microarray-based assay were CTX-M-15-like (n = 307), KPC (n = 120), SHV ESBLs
(n = 118), and CTX-M-14-like (n = 110). KPC producers were highly resistant to
comparators, and ceftazidime-avibactam (MIC50/90, 0.5/2 ?g/ml) and tigecycline
(MIC50/90, 0.5/1 ?g/ml; 98.3% susceptible) were the most active agents against
these strains. Meropenem (MIC50/90, ?0.06/?0.06 ?g/ml) and ceftazidime-avibactam
(MIC50/90, 0.12/0.25 ?g/ml) were active against CTX-M-producing isolates. Other
enzymes were also observed, and ceftazidime-avibactam displayed good activity
against the isolates producing less common enzymes. Among 11 isolates displaying
ceftazidime-avibactam MIC values of >8 ?g/ml, three were K. pneumoniae strains
producing metallo-?-lactamases (all ceftazidime-avibactam MICs, >32 ?g/ml), with
two NDM-1 producers and one K. pneumoniae strain carrying the bla(KPC-2) and
bla(VIM-4) genes. Therapeutic options for isolates producing ?-lactamases may be
limited, and ceftazidime-avibactam, which displayed good activity against
strains, including those producing KPC enzymes, merits further study in
infections where such organisms occur.