In Vitro Activity of Ceftazidime-Avibactam against 3rd Generation Cephalosporin and Carbapenem Resistant Gram-Negative Bacteria Obtained from Blood and Fecal Samples of Hematopoietic Stem Cell Transplanted Patients
Journal: Acta Microbiologica Bulgarica (Vol.39, No. 1)Publication Date: 2023-03-01
Authors : Niyazi D. Stoeva T.;
Page : 78-82
Keywords : antimicrobial resistance; ceftazidime-avibactam; hematopoietic stem cell transplantation; ESBL; carbapenem-resistant;
Abstract
The recipients of hematopoietic stem cell transplantation (HSCT) tend to develop invasive infections because of the immunosuppression caused by the underlying disease or the transplantation itself. The gastro¬intestinal tract is the major source of causative agents, often demonstrating multidrug resistance. The aim of this study is to investigate the in vitro activity of ceftazidime-avibactam (CZA) against 3rd generation ceph¬alosporin and/or carbapenem resistant (CPR) Gram-negative bacteria obtained from blood and fecal sam¬ples of patients following HSCT. Thirty-five clinical isolates were studied (Enterobacterales, n=25, Pseu-domanas spp., n=8, A. baumannii, n=2). MALDI Biotyper (Bruker) and Phoenix system (BD) were used for identification and susceptibility testing. Multiplex PCR was performed to detect genes associated with beta-lactam resistance. In the studied group 96% of the enteric bacteria were Extended Spectrum Beta Lacta¬mase producers (ESBL) and all were susceptible to CZA. CZA demonstrated an excellent activity against piperacillin-tazobactam resistant isolates. Among the CPR isolates, 91% were CZA resistant and blaVIM, blaOXA-23 and blaOXA-24/40, blaOXA-48 genes were detected. In conclusion, an excellent activity of CZA against ESBL producing and piperacillin-tazobactam resistant Gram - negative isolates was found. Despite its potent activity against class A enzymes, avibactam failed to inactivate class B and class D carbapenemases.
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