Antimicrobial Activity of Ceftazidime-Avibactam (CAZ-AVI) among the Carbapenemase-Producing Gram-negative Rods Isolated from Clinical Samples
Introduction: Treating Gram-negative bacteria that produce extendedspectrum beta-lactamases (ESBLs), AmpC Beta lactamases, and carbapenemases is a significant clinical concern worldwide. To address this concern, Ceftazidime-Avibactam has been approved by the United States Food and Drug Administr...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Pasteur Institute of Iran
2023-06-01
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| Series: | Journal of Medical Microbiology and Infectious Diseases |
| Subjects: | |
| Online Access: | https://jommid.pasteur.ac.ir/article-1-508-en.html |
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| Summary: | Introduction: Treating Gram-negative bacteria that produce extendedspectrum
beta-lactamases (ESBLs), AmpC Beta lactamases, and
carbapenemases is a significant clinical concern worldwide. To address this
concern, Ceftazidime-Avibactam has been approved by the United States
Food and Drug Administration (USFDA) as a practical option for combating
multi-drug resistant (MDR) and extensively drug-resistant (XDR)
organisms. Our study focused on determining the extent to which MDR
Gram-negative organisms from various clinical samples exhibited resistance
to CAZ-AVI. Methods: Conducted at a central India tertiary care teaching
hospital, our prospective study analyzed 258 Gram-negative bacteria
specimens. These bacterial strains were identified using standard
biochemical tests. ESBL production was detected using the combination disk
method, while the AmpC enzyme was detected using the Epsilometer test
(E-test). Furthermore, we assessed carbapenemase production using disk
diffusion methods. Our study used the E-test to identify Metallo-betalactamases
and Klebsiella pneumonia carbapenemase (KPC) activity.
Additionally, we utilized the E-test to analyze the susceptibility patterns of
CAZ-AVI. Results: Of the 258 Gram-negative isolates studied, 214 (83%)
were ESBL producers. Among these isolates, 90 (35%) showed evidence of
AmpC beta-lactamase production, with 17 (19%) being pure AmpC
producers and 73 (81%) being ESBL co-producers. 55 (21.50%) were found
to be carbapenemase producers. Among these isolates, 34 (62%) were MBL
producers, while 11 (20%) were KPC producers. Of the carbapenemaseproducing
isolates, 14 (25.50%) were resistant to CAZ-AVI. Among the
MDR isolates, we found that CI 109 (90%), PB 118 (97.50%), and FO 113
(93.50%) were the most effective antimicrobial agents. Conclusions: Gramnegative
organisms that produce ESBL, AmpC, Carbapenemase, MBL, and
KPC are particularly challenging for clinicians and a significant threat
worldwide. However, our study results suggest that CAZ-AVI could be an
effective standard therapy for managing MDR Gram-negative organisms. |
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| ISSN: | 2345-5349 2345-5330 |