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Infect Drug Resist. 2019 Mar 4;12:545-552. doi: 10.2147/IDR.S193638. eCollection 2019.

Antimicrobial activities of ceftazidime-avibactam, ceftolozane-tazobactam, and other agents against Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa isolated from intensive care units in Taiwan: results from the Surveillance of Multicenter Antimicrobial Resistance in Taiwan in 2016.

Liao CH1,2, Lee NY3, Tang HJ4,5, Lee SS6,7, Lin CF8, Lu PL9,10,11, Wu JJ12, Ko WC13, Lee WS14, Hsueh PR15,16.

Author information

1
Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
2
Department of Medicine, Yang-Ming University, Taipei, Taiwan.
3
Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan.
4
Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
5
Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
6
Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
7
Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.
8
Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
9
Department of Internal Medicine, Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
10
Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
11
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
12
Department of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan.
13
Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
14
Division of Infectious Diseases, Department of Internal Medicine, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan.
15
Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, hsporen@ntu.edu.tw.
16
Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, hsporen@ntu.edu.tw.

Abstract

Objective:

The aim of this study was to investigate the in vitro antimicrobial susceptibilities of clinically important Gram-negative bacteria from seven intensive care units in Taiwan in 2016.

Materials and methods:

In total, 300 non-duplicate isolates of Escherichia coli (n=100), Klebsiella pneumoniae (n=100), and Pseudomonas aeruginosa (n=100) collected from 300 patients were studied. The minimum inhibitory concentrations (MICs) of these isolates to antimicrobial agents were determined using the broth microdilution method. Carbapenemase-encoding genes (bla KPC, bla NDM, bla IMP, bla VIM, and bla OXA-48-like) were studied for the isolates that were not susceptible to any carbapenems. Sequencing analysis of the mcr genes (mcr-1-5) was conducted for all isolates with colistin MICs ≥4 mg/L.

Results:

Ertapenem non-susceptibility was detected in 3% (n=3) E. coli and 12% (n=12) K. pneumoniae isolates. The susceptibility rates of imipenem, ceftazidime-avibactam (CAZ-AVB), and ceftolozane-tazobactam (CLZ-TAZ) were 99%, 99%, and 88%, respectively, for E. coli, 91%, 100%, and 80%, respectively, for K. pneumoniae, and 66%, 91%, and 93%, respectively, for P. aeruginosa. Carbapenemase-encoding genes were not detected in E. coli, were detected in four (33.3%) K. pneumoniae isolates that were not susceptible to ertapenem (three harboring bla KPC and one harboring bla OXA-48-like), and were not detected in P. aeruginosa isolates that were not susceptible to imipenem. One K. pneumoniae isolate was resistant to colistin (MIC 4 mg/L) and negative for mcr genes.

Conclusion:

CAZ-AVB exhibited excellent activity against carbapenem-resistant Enterobacteriaceae, and CLZ-TAZ exhibited good activity against imipenem-resistant P. aeruginosa.

KEYWORDS:

carbapenem resistance; carbapenemase-encoding genes; mcr; second-generation; β-lactam; β-lactamase inhibitor combinations

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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