Inoculum effect of Enterobacterales co-expressing OXA-48 and CTX-M on the susceptibility to ceftazidime/avibactam and meropenem.
CTX-M
Ceftazidime/avibactam
Enterobacterales
Inoculum effect
Meropenem
OXA-48
Journal
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
ISSN: 1435-4373
Titre abrégé: Eur J Clin Microbiol Infect Dis
Pays: Germany
ID NLM: 8804297
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
08
10
2021
accepted:
09
03
2022
pubmed:
25
3
2022
medline:
27
4
2022
entrez:
24
3
2022
Statut:
ppublish
Résumé
The treatment of infections caused by OXA-48/CTX-M-coproducing Enterobacterales may be based on new beta-lactam/beta-lactamase inhibitors, such as ceftazidime/avibactam (CZA), or on high dose of meropenem (MER). However, bacterial density at the infection site may vary widely, and the inoculum effect of such antimicrobial strategies has never been specifically investigated. To determine if CZA or MER susceptibilities are impacted by high inocula of Enterobacterales co-expressing both enzymes: OXA-48 like and CTX-M. Determination of an inoculum effect was performed with a standard inoculum of 10 Thirty-nine isolates of ceftazidime-resistant Enterobacterales were included of which 27 (70%) co-expressed OXA-48 + CTX-M-15, 6 (15%) OXA-48 + CTX-M-14, and 6 (15%) OXA-181 + CTX-M-15. The susceptibility to the CZA combination was preserved whatever the inoculum used. Regarding MER, 24 (61.5%) of the isolates were susceptible to MER with the standard inoculum, 19 (48.7%) with a twofold increase, and only 15 (38.5%) with a tenfold increase. We showed that in vitro inoculum effect was observed with meropenem but not with CZA for OXA-48- combined with CTX-M-producing Enterobacterales.
Sections du résumé
BACKGROUND
BACKGROUND
The treatment of infections caused by OXA-48/CTX-M-coproducing Enterobacterales may be based on new beta-lactam/beta-lactamase inhibitors, such as ceftazidime/avibactam (CZA), or on high dose of meropenem (MER). However, bacterial density at the infection site may vary widely, and the inoculum effect of such antimicrobial strategies has never been specifically investigated. To determine if CZA or MER susceptibilities are impacted by high inocula of Enterobacterales co-expressing both enzymes: OXA-48 like and CTX-M.
METHODS
METHODS
Determination of an inoculum effect was performed with a standard inoculum of 10
RESULTS
RESULTS
Thirty-nine isolates of ceftazidime-resistant Enterobacterales were included of which 27 (70%) co-expressed OXA-48 + CTX-M-15, 6 (15%) OXA-48 + CTX-M-14, and 6 (15%) OXA-181 + CTX-M-15. The susceptibility to the CZA combination was preserved whatever the inoculum used. Regarding MER, 24 (61.5%) of the isolates were susceptible to MER with the standard inoculum, 19 (48.7%) with a twofold increase, and only 15 (38.5%) with a tenfold increase.
CONCLUSION
CONCLUSIONS
We showed that in vitro inoculum effect was observed with meropenem but not with CZA for OXA-48- combined with CTX-M-producing Enterobacterales.
Identifiants
pubmed: 35322329
doi: 10.1007/s10096-022-04430-7
pii: 10.1007/s10096-022-04430-7
doi:
Substances chimiques
Anti-Bacterial Agents
0
Azabicyclo Compounds
0
Drug Combinations
0
avibactam, ceftazidime drug combination
0
beta-Lactamase Inhibitors
0
avibactam
7352665165
Ceftazidime
9M416Z9QNR
beta-Lactamases
EC 3.5.2.6
Meropenem
FV9J3JU8B1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
853-858Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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