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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Pasteur Institute of Iran
2023-06-01
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| Series: | Journal of Medical Microbiology and Infectious Diseases |
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| Online Access: | https://jommid.pasteur.ac.ir/article-1-508-en.html |
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| author | Ravi Kumar Sharma1 Monica Monica1 Arindam Chakraborty1* |
| author_facet | Ravi Kumar Sharma1 Monica Monica1 Arindam Chakraborty1* |
| author_sort | Ravi Kumar Sharma1 |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-5f2ff114afba4c54a3eb3ab7a7d59e79 |
| institution | DOAJ |
| issn | 2345-5349 2345-5330 |
| language | English |
| publishDate | 2023-06-01 |
| publisher | Pasteur Institute of Iran |
| record_format | Article |
| series | Journal of Medical Microbiology and Infectious Diseases |
| spelling | doaj-art-5f2ff114afba4c54a3eb3ab7a7d59e792025-08-20T03:09:17ZengPasteur Institute of IranJournal of Medical Microbiology and Infectious Diseases2345-53492345-53302023-06-0111210310910.61186/JoMMID.11.2.103Antimicrobial Activity of Ceftazidime-Avibactam (CAZ-AVI) among the Carbapenemase-Producing Gram-negative Rods Isolated from Clinical SamplesRavi Kumar Sharma10https://orcid.org/0009-0009-4028-5147Monica Monica11https://orcid.org/0000-0001-9379-947XArindam Chakraborty1*2https://orcid.org/0000-0002-4741-23741Department of Microbiology, Motilal Nehru Medical College, Prayagraj, Uttar Pradesh, India1Department of Microbiology, Motilal Nehru Medical College, Prayagraj, Uttar Pradesh, India1Department of Microbiology, Motilal Nehru Medical College, Prayagraj, Uttar Pradesh, IndiaIntroduction: 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.https://jommid.pasteur.ac.ir/article-1-508-en.htmlcaz-avicarbapenemasemblmdrgram-negative organism |
| spellingShingle | Ravi Kumar Sharma1 Monica Monica1 Arindam Chakraborty1* Antimicrobial Activity of Ceftazidime-Avibactam (CAZ-AVI) among the Carbapenemase-Producing Gram-negative Rods Isolated from Clinical Samples Journal of Medical Microbiology and Infectious Diseases caz-avi carbapenemase mbl mdr gram-negative organism |
| title | Antimicrobial Activity of Ceftazidime-Avibactam (CAZ-AVI) among the Carbapenemase-Producing Gram-negative Rods Isolated from Clinical Samples |
| title_full | Antimicrobial Activity of Ceftazidime-Avibactam (CAZ-AVI) among the Carbapenemase-Producing Gram-negative Rods Isolated from Clinical Samples |
| title_fullStr | Antimicrobial Activity of Ceftazidime-Avibactam (CAZ-AVI) among the Carbapenemase-Producing Gram-negative Rods Isolated from Clinical Samples |
| title_full_unstemmed | Antimicrobial Activity of Ceftazidime-Avibactam (CAZ-AVI) among the Carbapenemase-Producing Gram-negative Rods Isolated from Clinical Samples |
| title_short | Antimicrobial Activity of Ceftazidime-Avibactam (CAZ-AVI) among the Carbapenemase-Producing Gram-negative Rods Isolated from Clinical Samples |
| title_sort | antimicrobial activity of ceftazidime avibactam caz avi among the carbapenemase producing gram negative rods isolated from clinical samples |
| topic | caz-avi carbapenemase mbl mdr gram-negative organism |
| url | https://jommid.pasteur.ac.ir/article-1-508-en.html |
| work_keys_str_mv | AT ravikumarsharma1 antimicrobialactivityofceftazidimeavibactamcazaviamongthecarbapenemaseproducinggramnegativerodsisolatedfromclinicalsamples AT monicamonica1 antimicrobialactivityofceftazidimeavibactamcazaviamongthecarbapenemaseproducinggramnegativerodsisolatedfromclinicalsamples AT arindamchakraborty1 antimicrobialactivityofceftazidimeavibactamcazaviamongthecarbapenemaseproducinggramnegativerodsisolatedfromclinicalsamples |