In vitro activity of ceftazidime–avibactam, ceftolozane–tazobactam, and other comparable agents against clinically important Gram-negative bacilli: Results from the 2017 surveillance of multicenter antimicrobial resistance in Taiwan (SMART)

Shio Shin Jean, Min Chi Lu, Zhi Yuan Shi, Shu Hui Tseng, Ting Shu Wu, Po Liang Lu, Pei Lan Shao, Wen Chien Ko, Fu Der Wang, Po Ren Hsueh

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives: We investigated the in vitro antimicrobial susceptibilities of clinically important Gram-negative bacteria (GNB) from 16 major teaching hospitals in Taiwan in 2017. Materials and methods: Escherichia coli (n=686) and Klebsiella pneumoniae bloodstream isolates (n=673), non-typhoid Salmonella (NTS; n=221) from various sources, Shigella species (n=21) from fecal samples, and Neisseria gonorrhoeae (n=129) from the genitourinary tract were collected. Antibiotic minimum inhibitory concentrations (MICs) were determined using the broth microdilution method. Alleles encoding K. pneumoniae carbapenemases (KPCs), New Delhi metallo-β-lactamases (NDMs), Verona integron-encoded metallo-β-lactamase, imipenemase, OXA-48-like, and mcr-1-5 genes were detected by molecular methods in Enterobacteriaceae isolates. Results: Five (0.7%) E. coli isolates harbored mcr-1 alleles. Twenty-four (3.6%), seven (1.0%), four (0.6%), and one (0.15%) K. pneumoniae isolates contained blaKPC, blaOXA-48-like, mcr-1, and blaNDM, respectively. Three (1.4%) NTS and no Shigella isolates harbored mcr-1 genes. Seventy-one (10.5%) K. pneumoniae isolates displayed non-susceptibility (NS) to carbapenem agent(s). Phenotypically extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae isolates showed significantly higher rates of ertapenem, tigecycline, and ceftolozane–tazobactam (CLZ– TAZ) NS (40.2%, 16.3%, and 71%–80%, respectively) than E. coli isolates exhibiting ESBL phenotypes (5.4%, 0.7%, and 18%–28%, respectively). All phenotypically ESBL-producing E. coli isolates were ceftazidime–avibactam (CAZ–AVB) susceptible. Two (8.3%) KPC-producing K. pneumoniae isolates showed CAZ–AVB NS. Hospital-acquired K. pneumoniae isolates were significantly less susceptible to ertapenem and CLZ–TAZ than hospital-acquired E. coli isolates. Conclusion: Third-generation cephalosporins remain the optimal choice for treating NTS, Shigella, and gonococcal infections in Taiwan. Hospital-acquired and phenotypically ESBL-producing K. pneumoniae are a heavy resistance burden in Taiwan.

Original languageEnglish
Pages (from-to)1983-1992
Number of pages10
JournalInfection and Drug Resistance
Volume11
DOIs
Publication statusPublished - Jan 1 2018

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Klebsiella pneumoniae
Taiwan
Bacillus
Shigella
Escherichia coli
Alleles
Integrons
In Vitro Techniques
Carbapenems
Neisseria gonorrhoeae
Microbial Sensitivity Tests
Enterobacteriaceae
Cephalosporins
Gram-Negative Bacteria
Teaching Hospitals
Salmonella
Genes
Anti-Bacterial Agents
Phenotype
Infection

Keywords

  • Carbapenemase
  • Ceftazidime-avibactam
  • Ceftolozane-tazobactam
  • Enterobacteriaceae
  • Extended-spectrum β-lactamases
  • Neisseria gonorrhoeae

ASJC Scopus subject areas

  • Pharmacology
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

In vitro activity of ceftazidime–avibactam, ceftolozane–tazobactam, and other comparable agents against clinically important Gram-negative bacilli : Results from the 2017 surveillance of multicenter antimicrobial resistance in Taiwan (SMART). / Jean, Shio Shin; Lu, Min Chi; Shi, Zhi Yuan; Tseng, Shu Hui; Wu, Ting Shu; Lu, Po Liang; Shao, Pei Lan; Ko, Wen Chien; Wang, Fu Der; Hsueh, Po Ren.

In: Infection and Drug Resistance, Vol. 11, 01.01.2018, p. 1983-1992.

Research output: Contribution to journalArticle

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title = "In vitro activity of ceftazidime–avibactam, ceftolozane–tazobactam, and other comparable agents against clinically important Gram-negative bacilli: Results from the 2017 surveillance of multicenter antimicrobial resistance in Taiwan (SMART)",
abstract = "Objectives: We investigated the in vitro antimicrobial susceptibilities of clinically important Gram-negative bacteria (GNB) from 16 major teaching hospitals in Taiwan in 2017. Materials and methods: Escherichia coli (n=686) and Klebsiella pneumoniae bloodstream isolates (n=673), non-typhoid Salmonella (NTS; n=221) from various sources, Shigella species (n=21) from fecal samples, and Neisseria gonorrhoeae (n=129) from the genitourinary tract were collected. Antibiotic minimum inhibitory concentrations (MICs) were determined using the broth microdilution method. Alleles encoding K. pneumoniae carbapenemases (KPCs), New Delhi metallo-β-lactamases (NDMs), Verona integron-encoded metallo-β-lactamase, imipenemase, OXA-48-like, and mcr-1-5 genes were detected by molecular methods in Enterobacteriaceae isolates. Results: Five (0.7{\%}) E. coli isolates harbored mcr-1 alleles. Twenty-four (3.6{\%}), seven (1.0{\%}), four (0.6{\%}), and one (0.15{\%}) K. pneumoniae isolates contained blaKPC, blaOXA-48-like, mcr-1, and blaNDM, respectively. Three (1.4{\%}) NTS and no Shigella isolates harbored mcr-1 genes. Seventy-one (10.5{\%}) K. pneumoniae isolates displayed non-susceptibility (NS) to carbapenem agent(s). Phenotypically extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae isolates showed significantly higher rates of ertapenem, tigecycline, and ceftolozane–tazobactam (CLZ– TAZ) NS (40.2{\%}, 16.3{\%}, and 71{\%}–80{\%}, respectively) than E. coli isolates exhibiting ESBL phenotypes (5.4{\%}, 0.7{\%}, and 18{\%}–28{\%}, respectively). All phenotypically ESBL-producing E. coli isolates were ceftazidime–avibactam (CAZ–AVB) susceptible. Two (8.3{\%}) KPC-producing K. pneumoniae isolates showed CAZ–AVB NS. Hospital-acquired K. pneumoniae isolates were significantly less susceptible to ertapenem and CLZ–TAZ than hospital-acquired E. coli isolates. Conclusion: Third-generation cephalosporins remain the optimal choice for treating NTS, Shigella, and gonococcal infections in Taiwan. Hospital-acquired and phenotypically ESBL-producing K. pneumoniae are a heavy resistance burden in Taiwan.",
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author = "Jean, {Shio Shin} and Lu, {Min Chi} and Shi, {Zhi Yuan} and Tseng, {Shu Hui} and Wu, {Ting Shu} and Lu, {Po Liang} and Shao, {Pei Lan} and Ko, {Wen Chien} and Wang, {Fu Der} and Hsueh, {Po Ren}",
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T1 - In vitro activity of ceftazidime–avibactam, ceftolozane–tazobactam, and other comparable agents against clinically important Gram-negative bacilli

T2 - Results from the 2017 surveillance of multicenter antimicrobial resistance in Taiwan (SMART)

AU - Jean, Shio Shin

AU - Lu, Min Chi

AU - Shi, Zhi Yuan

AU - Tseng, Shu Hui

AU - Wu, Ting Shu

AU - Lu, Po Liang

AU - Shao, Pei Lan

AU - Ko, Wen Chien

AU - Wang, Fu Der

AU - Hsueh, Po Ren

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: We investigated the in vitro antimicrobial susceptibilities of clinically important Gram-negative bacteria (GNB) from 16 major teaching hospitals in Taiwan in 2017. Materials and methods: Escherichia coli (n=686) and Klebsiella pneumoniae bloodstream isolates (n=673), non-typhoid Salmonella (NTS; n=221) from various sources, Shigella species (n=21) from fecal samples, and Neisseria gonorrhoeae (n=129) from the genitourinary tract were collected. Antibiotic minimum inhibitory concentrations (MICs) were determined using the broth microdilution method. Alleles encoding K. pneumoniae carbapenemases (KPCs), New Delhi metallo-β-lactamases (NDMs), Verona integron-encoded metallo-β-lactamase, imipenemase, OXA-48-like, and mcr-1-5 genes were detected by molecular methods in Enterobacteriaceae isolates. Results: Five (0.7%) E. coli isolates harbored mcr-1 alleles. Twenty-four (3.6%), seven (1.0%), four (0.6%), and one (0.15%) K. pneumoniae isolates contained blaKPC, blaOXA-48-like, mcr-1, and blaNDM, respectively. Three (1.4%) NTS and no Shigella isolates harbored mcr-1 genes. Seventy-one (10.5%) K. pneumoniae isolates displayed non-susceptibility (NS) to carbapenem agent(s). Phenotypically extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae isolates showed significantly higher rates of ertapenem, tigecycline, and ceftolozane–tazobactam (CLZ– TAZ) NS (40.2%, 16.3%, and 71%–80%, respectively) than E. coli isolates exhibiting ESBL phenotypes (5.4%, 0.7%, and 18%–28%, respectively). All phenotypically ESBL-producing E. coli isolates were ceftazidime–avibactam (CAZ–AVB) susceptible. Two (8.3%) KPC-producing K. pneumoniae isolates showed CAZ–AVB NS. Hospital-acquired K. pneumoniae isolates were significantly less susceptible to ertapenem and CLZ–TAZ than hospital-acquired E. coli isolates. Conclusion: Third-generation cephalosporins remain the optimal choice for treating NTS, Shigella, and gonococcal infections in Taiwan. Hospital-acquired and phenotypically ESBL-producing K. pneumoniae are a heavy resistance burden in Taiwan.

AB - Objectives: We investigated the in vitro antimicrobial susceptibilities of clinically important Gram-negative bacteria (GNB) from 16 major teaching hospitals in Taiwan in 2017. Materials and methods: Escherichia coli (n=686) and Klebsiella pneumoniae bloodstream isolates (n=673), non-typhoid Salmonella (NTS; n=221) from various sources, Shigella species (n=21) from fecal samples, and Neisseria gonorrhoeae (n=129) from the genitourinary tract were collected. Antibiotic minimum inhibitory concentrations (MICs) were determined using the broth microdilution method. Alleles encoding K. pneumoniae carbapenemases (KPCs), New Delhi metallo-β-lactamases (NDMs), Verona integron-encoded metallo-β-lactamase, imipenemase, OXA-48-like, and mcr-1-5 genes were detected by molecular methods in Enterobacteriaceae isolates. Results: Five (0.7%) E. coli isolates harbored mcr-1 alleles. Twenty-four (3.6%), seven (1.0%), four (0.6%), and one (0.15%) K. pneumoniae isolates contained blaKPC, blaOXA-48-like, mcr-1, and blaNDM, respectively. Three (1.4%) NTS and no Shigella isolates harbored mcr-1 genes. Seventy-one (10.5%) K. pneumoniae isolates displayed non-susceptibility (NS) to carbapenem agent(s). Phenotypically extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae isolates showed significantly higher rates of ertapenem, tigecycline, and ceftolozane–tazobactam (CLZ– TAZ) NS (40.2%, 16.3%, and 71%–80%, respectively) than E. coli isolates exhibiting ESBL phenotypes (5.4%, 0.7%, and 18%–28%, respectively). All phenotypically ESBL-producing E. coli isolates were ceftazidime–avibactam (CAZ–AVB) susceptible. Two (8.3%) KPC-producing K. pneumoniae isolates showed CAZ–AVB NS. Hospital-acquired K. pneumoniae isolates were significantly less susceptible to ertapenem and CLZ–TAZ than hospital-acquired E. coli isolates. Conclusion: Third-generation cephalosporins remain the optimal choice for treating NTS, Shigella, and gonococcal infections in Taiwan. Hospital-acquired and phenotypically ESBL-producing K. pneumoniae are a heavy resistance burden in Taiwan.

KW - Carbapenemase

KW - Ceftazidime-avibactam

KW - Ceftolozane-tazobactam

KW - Enterobacteriaceae

KW - Extended-spectrum β-lactamases

KW - Neisseria gonorrhoeae

KW - Carbapenemase

KW - Ceftazidime-avibactam

KW - Ceftolozane-tazobactam

KW - Enterobacteriaceae

KW - Extended-spectrum β-lactamases

KW - Neisseria gonorrhoeae

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U2 - 10.2147/IDR.S175679

DO - 10.2147/IDR.S175679

M3 - Article

AN - SCOPUS:85057576101

VL - 11

SP - 1983

EP - 1992

JO - Infection and Drug Resistance

JF - Infection and Drug Resistance

SN - 1178-6973

ER -