In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula
Objectives: Our aim was to assess the susceptibility of carbapenem-resistant Enterobacterales (CRE) from the Arabian Peninsula to a broad spectrum of antibiotics, including fosfomycin, ceftazidime-avibactam, and aztreonam-avibactam. Methods: 1192 non-repeat CRE isolated in 2009–2017 from 33 hospital...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-10-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971220305944 |
| _version_ | 1828519013287723008 |
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| author | Ágnes Sonnevend Akela Ghazawi Dania Darwish Greeshma Barathan Rayhan Hashmey Tanveer Ashraf Tahir A. Rizvi Tibor Pál |
| author_facet | Ágnes Sonnevend Akela Ghazawi Dania Darwish Greeshma Barathan Rayhan Hashmey Tanveer Ashraf Tahir A. Rizvi Tibor Pál |
| author_sort | Ágnes Sonnevend |
| collection | DOAJ |
| description | Objectives: Our aim was to assess the susceptibility of carbapenem-resistant Enterobacterales (CRE) from the Arabian Peninsula to a broad spectrum of antibiotics, including fosfomycin, ceftazidime-avibactam, and aztreonam-avibactam. Methods: 1192 non-repeat CRE isolated in 2009–2017 from 33 hospitals in five countries of the Arabian Peninsula were tested. The minimum inhibitory concentration of 14 antibiotics was determined. Carbapenemase and 16S methylase genes were detected by PCR. Clonality was assessed by PFGE. Results: The highest rate of susceptibility was detected to aztreonam-avibactam (95.5%) followed by colistin (79.8%), fosfomycin (71.8%) and tigecycline (59.9%). Isolates co-producing two carbapenemases (12.4%) were the least susceptible. Aminoglycoside susceptibility was affected by the frequent production of a 16S methylase. Susceptibility to ceftazidime-avibactam was impacted by the high rate of metallo-beta-lactamase producers (46.3%), while aztreonam-avibactam resistance occurred mostly in clonally unrelated, carbapenemase non-producing Escherichia coli. Conclusion: Of the currently available drugs: colistin, tigecycline, and ceftazidime-avibactam co-administered with aztreonam appear to be the most effective to treat CRE infections. However, the presence of non-clonal CRE isolates, in which avibactam does not lower the aztreonam MIC below the clinical breakpoint, is of notable concern. Based on the relatively high rate of fosfomycin susceptibility, it would be desirable to license parenteral fosfomycin in the region. |
| first_indexed | 2024-12-11T19:04:42Z |
| format | Article |
| id | doaj.art-bbbc59aa98f14ebea62b95c4a4918637 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-11T19:04:42Z |
| publishDate | 2020-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-bbbc59aa98f14ebea62b95c4a49186372022-12-22T00:53:56ZengElsevierInternational Journal of Infectious Diseases1201-97122020-10-0199253259In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian PeninsulaÁgnes Sonnevend0Akela Ghazawi1Dania Darwish2Greeshma Barathan3Rayhan Hashmey4Tanveer Ashraf5Tahir A. Rizvi6Tibor Pál7Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Pécs, Pécs, HungaryDepartment of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab EmiratesDepartment of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab EmiratesDepartment of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab EmiratesDepartment of Medicine, Tawam Hospital, Al Ain, United Arab EmiratesDepartment of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab EmiratesDepartment of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab EmiratesDepartment of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Pécs, Pécs, Hungary; Corresponding author at: Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Pécs, Szigeti út 12, Pécs 7624, Hungary.Objectives: Our aim was to assess the susceptibility of carbapenem-resistant Enterobacterales (CRE) from the Arabian Peninsula to a broad spectrum of antibiotics, including fosfomycin, ceftazidime-avibactam, and aztreonam-avibactam. Methods: 1192 non-repeat CRE isolated in 2009–2017 from 33 hospitals in five countries of the Arabian Peninsula were tested. The minimum inhibitory concentration of 14 antibiotics was determined. Carbapenemase and 16S methylase genes were detected by PCR. Clonality was assessed by PFGE. Results: The highest rate of susceptibility was detected to aztreonam-avibactam (95.5%) followed by colistin (79.8%), fosfomycin (71.8%) and tigecycline (59.9%). Isolates co-producing two carbapenemases (12.4%) were the least susceptible. Aminoglycoside susceptibility was affected by the frequent production of a 16S methylase. Susceptibility to ceftazidime-avibactam was impacted by the high rate of metallo-beta-lactamase producers (46.3%), while aztreonam-avibactam resistance occurred mostly in clonally unrelated, carbapenemase non-producing Escherichia coli. Conclusion: Of the currently available drugs: colistin, tigecycline, and ceftazidime-avibactam co-administered with aztreonam appear to be the most effective to treat CRE infections. However, the presence of non-clonal CRE isolates, in which avibactam does not lower the aztreonam MIC below the clinical breakpoint, is of notable concern. Based on the relatively high rate of fosfomycin susceptibility, it would be desirable to license parenteral fosfomycin in the region.http://www.sciencedirect.com/science/article/pii/S1201971220305944Carbapenem-resistant EnterobacteralesColistinCeftazidime-avibactamAztreonam-avibactamFosfomycin |
| spellingShingle | Ágnes Sonnevend Akela Ghazawi Dania Darwish Greeshma Barathan Rayhan Hashmey Tanveer Ashraf Tahir A. Rizvi Tibor Pál In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula International Journal of Infectious Diseases Carbapenem-resistant Enterobacterales Colistin Ceftazidime-avibactam Aztreonam-avibactam Fosfomycin |
| title | In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula |
| title_full | In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula |
| title_fullStr | In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula |
| title_full_unstemmed | In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula |
| title_short | In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula |
| title_sort | in vitro efficacy of ceftazidime avibactam aztreonam avibactam and other rescue antibiotics against carbapenem resistant enterobacterales from the arabian peninsula |
| topic | Carbapenem-resistant Enterobacterales Colistin Ceftazidime-avibactam Aztreonam-avibactam Fosfomycin |
| url | http://www.sciencedirect.com/science/article/pii/S1201971220305944 |
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