Evaluation of in Vitro Activity of Ceftazidime/Avibactam and Ceftolozane/Tazobactam against ESBL-producing Enterobacterales Isolated from Intensive Care Units from Qatar
Objectives: Extended-spectrum β-lactamases (ESBLs) mechanism of resistance in Enterobacterales leads to poor clinical outcomes. Ceftazidime/avibactam and ceftolozane/tazobactam are two broad-spectrum antimicrobial combinations that are effective against multidrug-resistant organisms with regional va...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Oman Medical Specialty Board
2022-09-01
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| Series: | Oman Medical Journal |
| Subjects: | |
| Online Access: | https://omjournal.org/articleDetails.aspx?coType=1&aId=3188 |
| _version_ | 1797998886688653312 |
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| author | Mazen A. Sid Ahmed Emad Bashir Ibrahim Jemal M. Hamid Joanne Daghfal Mohammed A. Alyazidi Aimen H. Abdelwahab Muna A. Al-Maslamani Abdul Latif Al Khal Hamad Abdel Hadi |
| author_facet | Mazen A. Sid Ahmed Emad Bashir Ibrahim Jemal M. Hamid Joanne Daghfal Mohammed A. Alyazidi Aimen H. Abdelwahab Muna A. Al-Maslamani Abdul Latif Al Khal Hamad Abdel Hadi |
| author_sort | Mazen A. Sid Ahmed |
| collection | DOAJ |
| description | Objectives: Extended-spectrum β-lactamases (ESBLs) mechanism of resistance in Enterobacterales leads to poor clinical outcomes. Ceftazidime/avibactam and ceftolozane/tazobactam are two broad-spectrum antimicrobial combinations that are effective against multidrug-resistant organisms with regional variations. This study aims to evaluate the antimicrobial susceptibility test (AST) for both combinations against ESBL-producing Enterobacterales isolated from intensive care units (ICUs) in tertiary hospitals from November 2012 to October 2013 in Qatar. Methods: A total of 629 Enterobacterales isolates from ICUs were screened for ESBL production using BD-PhoenixTM confirmed by double-disk potentiation, while ESBL-genes were detected by polymerase chain reaction. The ASTs for ceftazidime/avibactam and ceftolozane/tazobactam were assessed by minimum inhibitory concentration (MIC) test strips. A single isolate that was resistant to both combinations was subjected to whole-genome sequencing. Results: The prevalence of ESBL-producing Enterobacterales isolated from ICUs was 17.3% (109/629) with predominance of Klebsiella pneumoniae (56/109; 51.4%) and Escherichia coli (38/109; 34.9%). The susceptibility of ceftazidime/avibactam and ceftolozane/tazobactam against ESBL-producers was 99.1% (108/109) and most (81/109; 74.3%) had MICs < 0.5 for both combinations. The predominant ESBL-gene was blaCTX-M (72/109; 66.1%). A single isolate that was resistant to both combinations harbored multiple ESBL resistant-genes including blaVEB-5 and blaVIM-2.Conclusions: ESBL-producing Enterobacterales isolated from ICUs were predominantly K. pneumoniae and E. coli, mainly harboring blaCTX-M gene. They were highly susceptible to ceftazidime/avibactam and ceftolozane/tazobactam suggesting potential alternatives to currently available therapeutic options. |
| first_indexed | 2024-04-11T10:55:52Z |
| format | Article |
| id | doaj.art-e6af5a2e723f4320852e56814f6bb6e3 |
| institution | Directory Open Access Journal |
| issn | 1999-768X 2070-5204 |
| language | English |
| last_indexed | 2024-04-11T10:55:52Z |
| publishDate | 2022-09-01 |
| publisher | Oman Medical Specialty Board |
| record_format | Article |
| series | Oman Medical Journal |
| spelling | doaj.art-e6af5a2e723f4320852e56814f6bb6e32022-12-22T04:28:46ZengOman Medical Specialty BoardOman Medical Journal1999-768X2070-52042022-09-01375e422e42210.5001/omj.2022.89Evaluation of in Vitro Activity of Ceftazidime/Avibactam and Ceftolozane/Tazobactam against ESBL-producing Enterobacterales Isolated from Intensive Care Units from QatarMazen A. Sid Ahmed0Emad Bashir Ibrahim1Jemal M. Hamid2Joanne Daghfal3Mohammed A. Alyazidi4Aimen H. Abdelwahab5Muna A. Al-Maslamani6Abdul Latif Al Khal7Hamad Abdel Hadi8Division of Microbiology, Department of Pathology and Laboratory Medicine, Hamad Medical Corporation, Doha, Qatar; The Life Science Centre, School of Science and Technology, Örebro University, Örebro, SwedenDivision of Microbiology, Department of Pathology and Laboratory Medicine, Hamad Medical Corporation, Doha, Qatar; Biomedical Research Centre, Qatar University, Doha, QatarDivision of Microbiology, Department of Pathology and Laboratory Medicine, Hamad Medical Corporation, Doha, QatarCommunicable Diseases Center, Hamad Medical Corporation, Doha, QatarDivision of Microbiology, Department of Pathology and Laboratory Medicine, Hamad Medical Corporation, Doha, QatarDivision of Microbiology, Department of Pathology and Laboratory Medicine, Hamad Medical Corporation, Doha, QatarCommunicable Diseases Center, Hamad Medical Corporation, Doha, Qatar; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, QatarCommunicable Diseases Center, Hamad Medical Corporation, Doha, Qatar; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, QatarCommunicable Diseases Center, Hamad Medical Corporation, Doha, Qatar; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, QatarObjectives: Extended-spectrum β-lactamases (ESBLs) mechanism of resistance in Enterobacterales leads to poor clinical outcomes. Ceftazidime/avibactam and ceftolozane/tazobactam are two broad-spectrum antimicrobial combinations that are effective against multidrug-resistant organisms with regional variations. This study aims to evaluate the antimicrobial susceptibility test (AST) for both combinations against ESBL-producing Enterobacterales isolated from intensive care units (ICUs) in tertiary hospitals from November 2012 to October 2013 in Qatar. Methods: A total of 629 Enterobacterales isolates from ICUs were screened for ESBL production using BD-PhoenixTM confirmed by double-disk potentiation, while ESBL-genes were detected by polymerase chain reaction. The ASTs for ceftazidime/avibactam and ceftolozane/tazobactam were assessed by minimum inhibitory concentration (MIC) test strips. A single isolate that was resistant to both combinations was subjected to whole-genome sequencing. Results: The prevalence of ESBL-producing Enterobacterales isolated from ICUs was 17.3% (109/629) with predominance of Klebsiella pneumoniae (56/109; 51.4%) and Escherichia coli (38/109; 34.9%). The susceptibility of ceftazidime/avibactam and ceftolozane/tazobactam against ESBL-producers was 99.1% (108/109) and most (81/109; 74.3%) had MICs < 0.5 for both combinations. The predominant ESBL-gene was blaCTX-M (72/109; 66.1%). A single isolate that was resistant to both combinations harbored multiple ESBL resistant-genes including blaVEB-5 and blaVIM-2.Conclusions: ESBL-producing Enterobacterales isolated from ICUs were predominantly K. pneumoniae and E. coli, mainly harboring blaCTX-M gene. They were highly susceptible to ceftazidime/avibactam and ceftolozane/tazobactam suggesting potential alternatives to currently available therapeutic options. https://omjournal.org/articleDetails.aspx?coType=1&aId=3188enterobacterialbeta-lactamase tem-11antimicrobial drug resistanceceftazidime-avibactamceftolozane-tazobactamqatar |
| spellingShingle | Mazen A. Sid Ahmed Emad Bashir Ibrahim Jemal M. Hamid Joanne Daghfal Mohammed A. Alyazidi Aimen H. Abdelwahab Muna A. Al-Maslamani Abdul Latif Al Khal Hamad Abdel Hadi Evaluation of in Vitro Activity of Ceftazidime/Avibactam and Ceftolozane/Tazobactam against ESBL-producing Enterobacterales Isolated from Intensive Care Units from Qatar Oman Medical Journal enterobacterial beta-lactamase tem-11 antimicrobial drug resistance ceftazidime-avibactam ceftolozane-tazobactam qatar |
| title | Evaluation of in Vitro Activity of Ceftazidime/Avibactam and Ceftolozane/Tazobactam against ESBL-producing Enterobacterales Isolated from Intensive Care Units from Qatar |
| title_full | Evaluation of in Vitro Activity of Ceftazidime/Avibactam and Ceftolozane/Tazobactam against ESBL-producing Enterobacterales Isolated from Intensive Care Units from Qatar |
| title_fullStr | Evaluation of in Vitro Activity of Ceftazidime/Avibactam and Ceftolozane/Tazobactam against ESBL-producing Enterobacterales Isolated from Intensive Care Units from Qatar |
| title_full_unstemmed | Evaluation of in Vitro Activity of Ceftazidime/Avibactam and Ceftolozane/Tazobactam against ESBL-producing Enterobacterales Isolated from Intensive Care Units from Qatar |
| title_short | Evaluation of in Vitro Activity of Ceftazidime/Avibactam and Ceftolozane/Tazobactam against ESBL-producing Enterobacterales Isolated from Intensive Care Units from Qatar |
| title_sort | evaluation of in vitro activity of ceftazidime avibactam and ceftolozane tazobactam against esbl producing enterobacterales isolated from intensive care units from qatar |
| topic | enterobacterial beta-lactamase tem-11 antimicrobial drug resistance ceftazidime-avibactam ceftolozane-tazobactam qatar |
| url | https://omjournal.org/articleDetails.aspx?coType=1&aId=3188 |
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