Phenotypic Ultra-Rapid Antimicrobial Susceptibility Testing for Ceftazidime–Avibactam: In Support of Antimicrobial Stewardship
Ceftazidime–avibactam (CZA) is a potent broad-spectrum drug combination covering extended-spectrum β-lactamases, AmpC, and carbapenemases of class A and D, OXA-48-type producers. Rapid antimicrobial susceptibility testing is crucial for the timely de-escalation/escalation of therapy. We evaluate CZA...
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MDPI AG
2025-02-01
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| author | Inês Martins-Oliveira Blanca Pérez-Viso Rosário Gomes David Abreu Ana Silva-Dias Rafael Cantón Cidália Pina-Vaz |
| author_facet | Inês Martins-Oliveira Blanca Pérez-Viso Rosário Gomes David Abreu Ana Silva-Dias Rafael Cantón Cidália Pina-Vaz |
| author_sort | Inês Martins-Oliveira |
| collection | DOAJ |
| description | Ceftazidime–avibactam (CZA) is a potent broad-spectrum drug combination covering extended-spectrum β-lactamases, AmpC, and carbapenemases of class A and D, OXA-48-type producers. Rapid antimicrobial susceptibility testing is crucial for the timely de-escalation/escalation of therapy. We evaluate CZA susceptibility using the CE-IVD FASTgramneg kit (FASTinov<sup>®</sup>), a ground-breaking 2 h assay, based on flow cytometry technology for antimicrobial susceptibility testing. The assay involved rapid bacterial extraction and purification from positive blood cultures (PBCs), followed by a 1 h 37 °C incubation and flow cytometry analysis (Cytoflex, Beckman-Coulter). The susceptibility report was generated using a proprietary software and interpreted using EUCAST and CLSI 2024 criteria. Sensitivity and specificity were calculated against a reference standardized method (disk diffusion) according to ISO20776-2:2021. Overall, 135 Enterobacterales and 73 <i>Pseudomonas aeruginosa</i> isolates were studied. Thirty-four isolates were resistant to CZA, including six <i>P. aeruginosa</i> and 28 Enterobacterales (24 metallo-beta-lactamase producers, three KPC variants, and one co-producing KPC+NDM). Sensitivity and specificity reached 100% when using EUCAST and CLSI criteria compared with the reference method. The FASTinov ultra-rapid susceptibility assay for CZA demonstrated excellent results, potentially enabling de-escalation/escalation even before the second dose. Combining the speed of a molecular assay with the comprehensive information of a phenotypic test offers valuable insights for treatment decisions. |
| format | Article |
| id | doaj-art-1df8ad9bbf8d4e5ead9a6821fb721775 |
| institution | DOAJ |
| issn | 2076-2607 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj-art-1df8ad9bbf8d4e5ead9a6821fb7217752025-08-20T02:44:47ZengMDPI AGMicroorganisms2076-26072025-02-0113241410.3390/microorganisms13020414Phenotypic Ultra-Rapid Antimicrobial Susceptibility Testing for Ceftazidime–Avibactam: In Support of Antimicrobial StewardshipInês Martins-Oliveira0Blanca Pérez-Viso1Rosário Gomes2David Abreu3Ana Silva-Dias4Rafael Cantón5Cidália Pina-Vaz6FASTinov, S.A., 4200-135 Porto, PortugalServicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, SpainFASTinov, S.A., 4200-135 Porto, PortugalFASTinov, S.A., 4200-135 Porto, PortugalFASTinov, S.A., 4200-135 Porto, PortugalServicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, SpainFASTinov, S.A., 4200-135 Porto, PortugalCeftazidime–avibactam (CZA) is a potent broad-spectrum drug combination covering extended-spectrum β-lactamases, AmpC, and carbapenemases of class A and D, OXA-48-type producers. Rapid antimicrobial susceptibility testing is crucial for the timely de-escalation/escalation of therapy. We evaluate CZA susceptibility using the CE-IVD FASTgramneg kit (FASTinov<sup>®</sup>), a ground-breaking 2 h assay, based on flow cytometry technology for antimicrobial susceptibility testing. The assay involved rapid bacterial extraction and purification from positive blood cultures (PBCs), followed by a 1 h 37 °C incubation and flow cytometry analysis (Cytoflex, Beckman-Coulter). The susceptibility report was generated using a proprietary software and interpreted using EUCAST and CLSI 2024 criteria. Sensitivity and specificity were calculated against a reference standardized method (disk diffusion) according to ISO20776-2:2021. Overall, 135 Enterobacterales and 73 <i>Pseudomonas aeruginosa</i> isolates were studied. Thirty-four isolates were resistant to CZA, including six <i>P. aeruginosa</i> and 28 Enterobacterales (24 metallo-beta-lactamase producers, three KPC variants, and one co-producing KPC+NDM). Sensitivity and specificity reached 100% when using EUCAST and CLSI criteria compared with the reference method. The FASTinov ultra-rapid susceptibility assay for CZA demonstrated excellent results, potentially enabling de-escalation/escalation even before the second dose. Combining the speed of a molecular assay with the comprehensive information of a phenotypic test offers valuable insights for treatment decisions.https://www.mdpi.com/2076-2607/13/2/414antimicrobial susceptibility testingceftazidime–avibactamGram-negative bacteriarapid diagnosticsflow cytometryantibiotic escalation/de-escalation |
| spellingShingle | Inês Martins-Oliveira Blanca Pérez-Viso Rosário Gomes David Abreu Ana Silva-Dias Rafael Cantón Cidália Pina-Vaz Phenotypic Ultra-Rapid Antimicrobial Susceptibility Testing for Ceftazidime–Avibactam: In Support of Antimicrobial Stewardship Microorganisms antimicrobial susceptibility testing ceftazidime–avibactam Gram-negative bacteria rapid diagnostics flow cytometry antibiotic escalation/de-escalation |
| title | Phenotypic Ultra-Rapid Antimicrobial Susceptibility Testing for Ceftazidime–Avibactam: In Support of Antimicrobial Stewardship |
| title_full | Phenotypic Ultra-Rapid Antimicrobial Susceptibility Testing for Ceftazidime–Avibactam: In Support of Antimicrobial Stewardship |
| title_fullStr | Phenotypic Ultra-Rapid Antimicrobial Susceptibility Testing for Ceftazidime–Avibactam: In Support of Antimicrobial Stewardship |
| title_full_unstemmed | Phenotypic Ultra-Rapid Antimicrobial Susceptibility Testing for Ceftazidime–Avibactam: In Support of Antimicrobial Stewardship |
| title_short | Phenotypic Ultra-Rapid Antimicrobial Susceptibility Testing for Ceftazidime–Avibactam: In Support of Antimicrobial Stewardship |
| title_sort | phenotypic ultra rapid antimicrobial susceptibility testing for ceftazidime avibactam in support of antimicrobial stewardship |
| topic | antimicrobial susceptibility testing ceftazidime–avibactam Gram-negative bacteria rapid diagnostics flow cytometry antibiotic escalation/de-escalation |
| url | https://www.mdpi.com/2076-2607/13/2/414 |
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