A practical laboratory method to determine ceftazidime-avibactam-aztreonam synergy in patients with New Delhi metallo-beta-lactamase (NDM)-producing Enterobacterales infection.
Aztreonam
Ceftazidime-avibactam
Combination treatment
New Delhi metallo-beta-lactamase
Synergy
Journal
Journal of global antimicrobial resistance
ISSN: 2213-7173
Titre abrégé: J Glob Antimicrob Resist
Pays: Netherlands
ID NLM: 101622459
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
16
08
2021
revised:
10
01
2022
accepted:
30
01
2022
pubmed:
9
2
2022
medline:
22
6
2022
entrez:
8
2
2022
Statut:
ppublish
Résumé
In response to infection with New Delhi metallo-beta-lactamase (NDM)-producing Enterobacterales, combination antimicrobial therapy with ceftazidime/avibactam (CAZ/AVI) plus aztreonam (ATM) has been explored. This study evaluated a practical laboratory method of testing for clinically significant synergy between CAZ/AVI+ATM in NDM-producing Enterobacterales. Minimum inhibitory concentrations (MICs) of clinical NDM-producing isolates were determined for ATM alone and CAZ/AVI+ATM using broth dilution. Restoration of the ATM breakpoint after the addition of CAZ/AVI was explored. A CAZ/AVI Etest/ATM disc method was compared with broth dilution. Of 43 isolates, 33 (77%) were ATM resistant (median [range] MIC = 56 [16-512] mg/L). Addition of CAZ/AVI restored the ATM breakpoint (MIC <4 mg/L) in 29 of 33 resistant isolates (89%). Overall, the Etest/disc method correlated with the findings from broth dilution in 35 of 43 cases (81%). Etest/disc sensitivity was 77% and specificity 85%. Positive predictive value was 92% and negative predictive value 61%. CAZ/AVI+ATM demonstrated significant synergy in most ATM-resistant NDM-producing Enterobacterales. The Etest/disc method is a quick, reproducible, and reliable method of testing for clinically relevant synergy in the microbiology laboratory.
Identifiants
pubmed: 35131508
pii: S2213-7165(22)00029-7
doi: 10.1016/j.jgar.2022.01.025
pii:
doi:
Substances chimiques
Azabicyclo Compounds
0
Drug Combinations
0
avibactam, ceftazidime drug combination
0
Ceftazidime
9M416Z9QNR
beta-Lactamases
EC 3.5.2.6
beta-lactamase NDM-1
EC 3.5.2.6
Aztreonam
G2B4VE5GH8
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
558-562Subventions
Organisme : Medical Research Council
ID : MR/T005254/1
Pays : United Kingdom
Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest TMR has consulted for/ received speaker fees from Sandoz (2020), bioMerieux (2021-2022), and Roche diagnostics (2021). LSPM has consulted for/received speaker fees from bioMerieux (2013-2022), Eumedica (2016-2022), Pfizer (2018-2022), Umovis Lab (2020-2021), Profile Pharma (2018), Shionogi (2020-2022), Kent Pharma (2021), Sumitovant (2021-2022), DNAelectronics (2015-18), Dairy Crest (2017–2018), and received research grants from the National Institute for Health Research (2013-2019), CW+ Charity (2018-2022), LifeArc (2020-2022), and Leo Pharma (2016). All other authors have no potential conflicts of interest to declare.