JOMPAC

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

EndNote Style
Index
Original Article
Evaluation of ceftazidime-avibactam susceptibility in carbapenem resistant Klebsiella pneumoniae and Pseudomonas aeruginosa isolates
Aims: Carbapenem-resistant Gram-negative microorganisms are gradually increasing in hospitalized patients in intensive care units and causes increased morbidity, mortality, and cost. This study aims to investigate the susceptibility of ceftazidime-avibactam (caz-avi), which has recently started to be used for the treatment of infections caused by carbapenem-resistant (CR) Gram-negative bacteria isolated from various samples received from the intensive care unit (ICU) of our hospital.
Methods: Carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) strains isolated from various clinical specimens that were sent to our laboratory between January 1st, 2021, and October 30th, 2022, were retrospectively evaluated in the study. The culture and antibiogram results of the samples were received over the laboratory information system (LIS) and evaluated using statistical analyses. Ceftazidime-avibactam susceptibility was studied using the disc diffusion method.
Results: Ceftazidime-avibactam antibiotic susceptibility test results of 352 (69.4%) CRKP and 155 (30.6%) CRPA strains isolated from various clinical samples from the ICU of our hospital were analyzed. Of the CRKP strains, 313 (88.9%) were found to be susceptible and 39 (11.1%) were found to be resistant to ceftazidime-avibactam. Of the CRPA strains, 131 (84.5%) were found to be susceptible and 24 (15.5%) were found to be resistant.
Conclusion: Determining the regional susceptibility of carbapenem-resistant strains isolated in our hospital to a new antimicrobial combination such as caz-avi will allow a better understanding of the spread of resistance.


1. Zasowski EJ, Rybak JM, Rybak MJ. The β-Lactams strike back:ceftazidime-avibactam. Pharmacotherapy. 2015;35(8):755-770.
2. Brooke JS. Stenotrophomonas maltophilia: an emerging globalopportunistic pathogen. Clin Microbiol Rev. 2012;25(1):2-41.
3. Zusman O, Altunin S, Koppel F, Dishon Benattar Y, Gedik H,Paul M. Polymyxin monotherapy or in combination againstcarbapenem-resistant bacteria: systematic review and meta-analysis. J Antimicrob Chemother. 2017;72(1):29-39.
4. Yang X, Wang D, Zhou Q, et al. Antimicrobial susceptibilitytesting of Enterobacteriaceae: determination of disk contentand Kirby-Bauer breakpoint for ceftazidime/avibactam. BMCMicrobiol. 2019;19(1):240.
5. Doi Y. Treatment options for carbapenem-resistantgram-negative bacterial infections. Clin Infect Dis.2019;69(Supplement_7):S565-S575.
6. Carmeli Y, Armstrong J, Laud PJ, et al. Ceftazidime-avibactamor best available therapy in patients with ceftazidime-resistantEnterobacteriaceae and Pseudomonas aeruginosa complicatedurinary tract infections or complicated intra-abdominalinfections (REPRISE): a randomised, pathogen-directed. LancetInfect Dis. 2016;16(6):661-673.
7. Bassetti M, Mularoni A, Giacobbe DR, Castaldo N, VenaA. New antibiotics for hospital-acquired pneumonia andventilator-associated pneumonia. Semin Respir Crit Care Med.2022;43(2):280-294.
8. Choi MH, Kim D, Lee KH, Cho JH, Jeong SH. Changes in theprevalence of pathogens causing hospital acquired bacterialpneumonia and the impact of their antimicrobial resistancepatterns on clinical outcomes: a propensity-score-matched study.Int J Antimicrob Agents. 2023;62(3):106886.
9. Karlowsky JA, Biedenbach DJ, Kazmierczak KM, Stone GG,Sahm DF. Activity of ceftazidime-avibactam against extended-spectrum- and AmpC β-lactamase-producing Enterobacteriaceaecollected in the INFORM global surveillance study from 2012 to2014. Antimicrob Agents Chemother. 2016;60(5):2849-2857.
10. Öztaş S, Er DK, Dündar D. Antimicrobial resistance ofvarious antimicrobial agents in carbapenem-resistant andsusceptible isolates of Klebsiella pneumoniae. KOU Sag Bil Derg.2022;8(3):229-232.
11. Arıcı N, Kansak N, Adaleti R, et al. Ventilatör ilişkili pnömonietkeni karbapenem dirençli Klebsiella pneumoniae vePseudomonas aeruginosa izolatlarında seftazidim-avibaktamın invitro etkinliği. ANKEM Derg. 2023;37(2):57-64.
12. Spiliopoulou I, Kazmierczak K, Stone GG. In vitro activity ofceftazidime/avibactam against isolates of carbapenem-non-susceptible Enterobacteriaceae collected during the INFORMglobal surveillance programme (2015-17). J AntimicrobChemother. 2020;75(2):384-391.
13. Sader HS, Castanheira M, Jones RN, Flamm RK. Antimicrobialactivity of ceftazidime-avibactam and comparator agents whentested against bacterial isolates causing infection in cancer patients(2013-2014). Diagn Microbiol Infect Dis. 2017;87(3):261-265.
14. Kempf M, Arhin FF, Stone G, Utt E. Ceftazidime-avibactam activityagainst Gram-negative respiratory isolates collected between 2018and 2019. J Glob Antimicrob Resist. 2022;31:239-247.
15. Ramadan RA, Bedawy AM, Negm EM, et al. Carbapenem-resistant Klebsiella pneumoniae among patients with ventilator-associated pneumonia: evaluation of antibiotic combinations andsusceptibility to new antibiotics. Infect Drug Resist. 2022;15:3537-3548.
16. Torrens G, van der Schalk TE, Cortes-Lara S, et al. Susceptibilityprofiles and resistance genomics of Pseudomonas aeruginosaisolates from European ICUs participating in the ASPIRE-ICUtrial. J Antimicrob Chemother. 2022;77(7):1862-1872.
17. Livermore DM, Meunier D, Hopkins KL, et al. Activity ofceftazidime-avibactam against problem Enterobacteriaceaeand Pseudomonas aeruginosa in the UK, 2015-16. J AntimicrobChemother. 2018; 73(3):648-657.
18. Castanheira M, Doyle TB, Hubler C, Sader HS, Mendes RE.Ceftazidime-avibactam activity against a challenge set ofcarbapenem-resistant Enterobacterales: Ompk36 L3 alterationsand β-lactamases with ceftazidime hydrolytic activity lead toelevated MIC values. Int J Antimicrob Agents. 2020;56(1):106011.
19. Isler B, Vatansever C, Özer B, et al. Comparison of ceftazidime-avibactam susceptibility testing methods against OXA-48-likecarrying Klebsiella blood stream isolates. Diagn Microbiol InfectDis. 2022;104(1):115745.
20. Mirza HC, Hortaç E, Koçak AA, et al. In vitro activity ofceftolozane-tazobactam and ceftazidime-avibactam againstclinical isolates of meropenem-non-susceptible Pseudomonasaeruginosa: a two-centre study. J Glob Antimicrob Resist.2020;20:334-338. doi.org/10.1016/j.jgar.2019.09.016
21. Hoşbul T, Aydoğan C, Kaya S, Bedir O, Özcan H, Gümral R.In vitro activity of ceftazidime-avibactam and colistin againstcarbapenem-resistant Pseudomonas aeruginosa clinical isolates. JIst Fac Med. 2022;85(3):355-361.
22. Shields RK, Nguyen MH, Chen L, et al. Ceftazidime-avibactamis superior to other treatment regimens against carbapenem-resistant Klebsiella pneumoniae bacteremia. Antimicrob AgentsChemother. 2017;61(8):10-1128. doi.org/10.1128/AAC.00883-17
23. King M, Heil E, Kuriakose S, et al. Multicenter study of outcomeswith ceftazidime-avibactam in patients with carbapenem-resistant Enterobacteriaceae infections. Antimicrob AgentsChemother. 2017;61(7)10-1128. doi.org/10.1128/AAC.00449-17
24. Yang X, Wang D, Zhou Q, et al. Antimicrobial susceptibilitytesting of Enterobacteriaceae: determination of disk contentand Kirby-Bauer breakpoint for ceftazidime/avibactam. BMCMicrobiol. 2019;19(1):240.
25. Çekin ZK, Dabos L, Malkoçoğlu G, et al. Carbapenemase-producing Pseudomonas aeruginosa isolates from Turkey: firstreport of P. aeruginosa high-risk clones with VIM-5- and IMP-7-type carbapenemases in a tertiary hospital. Diagn Microbiol InfectDis. 2021;99(1):115174.
26. T.C. Resmi Gazete. Sosyal güvenlik kurumu sağlık uygulama tebliğindedeğişiklik yapılmasına dair tebliğ. 28.04.2021. Available from: https://www.resmigazete.gov.tr/eskiler/2021/04/20210428M1-1.htm
Volume 4, Issue 6, 2023
Page : 625-629
_Footer