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  2. Ceftazidime - Avibactam susceptibility among carbapenem-resistant Enterobacterales in a pilot study in Turkey

Ceftazidime - Avibactam susceptibility among carbapenem-resistant Enterobacterales in a pilot study in Turkey

  • Acta Microbiol Immunol Hung. 2021 Jul 29. doi: 10.1556/030.2021.01525.
Hasan Selcuk Ozger 1 Ebru Evren 2 Serap Suzuk Yildiz 3 Cigdem Erol 4 Fatma Bayrakdar 3 Ozlem Azap 4 Alpay Azap 5 Esin Senol 1
Affiliations

Affiliations

  • 1 1Gazi University, Medical School Department of Infectious Diseases,Turkey.
  • 2 2Ankara University, Medical School Department of Medical Microbiology, Turkey.
  • 3 3Ministry of Health General Directorate of Public Health, Department of Microbiology, Reference Laboratory and Biological Products,Turkey.
  • 4 4Baskent University, Medical School Department of Infectious Diseases and Clinical Microbiology, Turkey.
  • 5 5Ankara University, Medical School Department of Infectious Diseases and Clinical Microbiology, Turkey.
Abstract

This study aimed to detect carbapenemase genes and to determine the in vitro susceptibility of Ceftazidime-Avibactam (CZA) in Enterobacterales isolates. Carbapenemase genes were detected by polymerase chain reaction. CZA sensitivity of isolates was evaluated with broth microdilution (BMD) and disk diffusion methods. A total of 318 carbapenem-resistant Enterobacterales isolates were included. Most of the isolates (n = 290, 91.2%) were identified as Klebsiella pneumoniae. The most common carbapenemase type was OXA-48 (n = 82, 27.6%). CZA susceptibility was evaluated in 84 isolates with OXA-48 and KPC carbapenemase activity. Both BMD and disk diffusion methods revealed that 95.2% of the isolates were sensitive to CZA; whereas, 4 (4.76%) isolates were resistant to CZA. Among colistin resistant isolates, 96.5% (n = 80) of them were susceptible to CZA. Our study demonstrated high in vitro efficacy of CZA in Enterobacterales isolates producing OXA-48 carbapenemase. High susceptibility rates against colistin resistant isolates which generally are also pan drug resistant, makes CZA a promising therapeutic choice for difficult-to-treat infections. Due to its high correlation with the BMD, disk diffusion method is a suitable and more practical method in detecting CZA in vitro activity.

Keywords

Enterobacterales; carbapenemase; ceftazidime-avibactam; colistin.

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