In Vitro Susceptibility of Aztreonam-Vaborbactam, Aztreonam-Relebactam and Aztreonam-Avibactam Associations against Metallo-β-Lactamase-Producing Gram-Negative Bacteria
-
Published:2023-09-29
Issue:10
Volume:12
Page:1493
-
ISSN:2079-6382
-
Container-title:Antibiotics
-
language:en
-
Short-container-title:Antibiotics
Author:
Emeraud Cécile12, Bernabeu Sandrine12, Dortet Laurent12ORCID
Affiliation:
1. Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique—Hôpitaux de Paris, 94270 Le Kremlin-Bicêtre, France 2. INSERM UMR 1184, RESIST Unit, Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
Abstract
Background: Despite the availability of new options (ceftazidime-avibactam, imipenem-relebactam, meropenem-vaborbactam and cefiderocol), it is still very difficult to treat infections caused by metallo-β-lactamase (MBLs)-producers resistant to aztreonam. The in vitro efficacy of aztreonam in association with avibactam, vaborbactam or relebactam was evaluated on a collection of MBL-producing Enterobacterales, MBL-producing P. aeruginosa and highly drug-resistant S. maltophilia. Methods: A total of fifty-two non-duplicate MBL-producing Enterobacterales, five MBL-producing P. aeruginosa and five multidrug-resistant S. maltophila isolates were used in this study. The minimum inhibitory concentrations (MICs) of aztreonam, meropenem-vaborbactam and imipenem-relebactam were determined by Etest® (bioMérieux, La Balme-les-Grottes) according to EUCAST recommendations. For aztreonam-avibactam, aztreonam-vaborbactam and aztreonam-relebactam associations, the MICs were determined using Etest® on Mueller-Hinton (MH) agar supplemented with 8 mg/L of avibactam, 8 mg/L of vaborbactam and 4 mg/L of relebactam. The MICs were interpreted according to EUCAST guidelines. Results: The susceptibility rates of aztreonam-avibactam, aztreonam-vaborbactam and aztreonam-relebactam with a standard exposure of aztreonam (1g × 3, IV) were 84.6% (44/52), 55.8% and 34.6% for Enterobacterales and 0% for all combinations for P. aeruginosa and S. maltophila. The susceptibility rates of aztreonam-avibactam, aztreonam-vaborbactam and aztreonam-relebactam with a high exposure of aztreonam (2g × 4, IV) were 92.3%, 78.9% and 57.7% for Enterobacterales, 75%, 60% and 60% for P. aeruginosa and 100%, 100% and 40% for S. maltophila. Conclusions: As previously demonstrated for an aztreonam/ceftazidime-avibactam combination, aztreonam plus imipenem-relebactam and aztreonam plus meropenem-vaborbactam might be useful options, but with potentially lower efficiency, to treat infections caused by aztreonam-non-susceptible MBL-producing Gram-negative strains.
Subject
Pharmacology (medical),Infectious Diseases,Microbiology (medical),General Pharmacology, Toxicology and Pharmaceutics,Biochemistry,Microbiology
Reference36 articles.
1. Structural and Functional Aspects of Class A Carbapenemases;Naas;Curr. Drug Targets,2016 2. B1-Metallo-beta-Lactamases: Where Do We Stand?;Mojica;Curr. Drug Targets,2016 3. OXA-48-like carbapenemases: The phantom menace;Poirel;J. Antimicrob. Chemother.,2012 4. Bonnin, R.A., Emeraud, C., Jousset, A.B., Naas, T., and Dortet, L. (2022). Comparison of disk diffusion, MIC test strip and broth microdilution methods for cefiderocol susceptibility testing on carbapenem-resistant enterobacterales. Clin. Microbiol. Infect., 28. 5. Emeraud, C., Escaut, L., Boucly, A., Fortineau, N., Bonnin, R.A., Naas, T., and Dortet, L. (2019). Aztreonam plus Clavulanate, Tazobactam, or Avibactam for Treatment of Infections Caused by Metallo-beta-Lactamase-Producing Gram-Negative Bacteria. Antimicrob. Agents Chemother., 63.
|
|