In vitro activity of avibactam (NXL104) in combination with β-lactams against Gram-negative bacteria, including OXA-48 β-lactamase-producing <i>Klebsiella pneumoniae</i>

Aktas Z., Kayacan C., Oncul O.

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, sa.1, ss.86-89, 2012 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2012
  • Doi Numarası: 10.1016/j.ijantimicag.2011.09.012
  • Dergi Adı: INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.86-89
  • Anahtar Kelimeler: Avibactam, beta-Lactamases, OXA-48, Gram-negative bacteria, PSEUDOMONAS-AERUGINOSA, ESCHERICHIA-COLI, TURKEY, ISTANBUL, PLASMIDS, ENTEROBACTERIACEAE, CARBAPENEMASES, CEFTAZIDIME, SPREAD
  • İstanbul Üniversitesi Adresli: Evet

Özet

The objective of this study was to investigate the in vitro antibacterial activity of avibactam (formerly NXL104) in combination with imipenem, cefepime or ceftazidime against Gram-negative bacteria. Bacterial isolates included: Pseudomonas aeruginosa harbouring PER-1 beta-lactamase (n = 14); Acinetobacter baumannii harbouring PER-1, OXA-51 and OXA-58 (n = 20); carbapenem-non-susceptible Klebsiella pneumoniae (n = 25) and Escherichia coli (n = 1) harbouring OXA-48; carbapenem-non-susceptible E. coli (n = 1) harbouring both IMP-1 metallo-beta-lactamase and extended-spectrum beta-lactamase (ESBL); carbapenem-non-susceptible Serratia marcescens (n = 1); and carbapenem-susceptible E. coli (n = 20) and K. pneumoniae isolates (n = 12) with CTX-M-15 ESBL. Minimum inhibitory concentrations (MICs) of imipenem, cefepime and ceftazidime were determined in combination with 4 mg/L avibactam by the Clinical and Laboratory Standards Institute (CLSI) method on Mueller-Hinton agar. Imipenem/avibactam and ceftazidime/avibactam displayed limited potency against A. baumannii isolates, whereas cefepime/avibactam and ceftazidime/avibactam were active against P. aeruginosa. Klebsiella pneumoniae isolates with OXA-48 beta-lactamase were resistant to imipenem [MIC for 90% of the organisms (MIC(90)) >= 4 mg/L]. MIC(90) values for the combination of avibactam 4 mg/L with imipenem, cefepime and ceftazidime were in the susceptible range for all strains (MIC(90) <= 0.5 mg/L). All E. coli and K. pneumoniae isolates with CTX-M-15 beta-lactamase were inhibited at <= 1 mg/L for combinations with avibactam and 100% were susceptible by CLSI breakpoint criteria to imipenem, cefepime and ceftazidime. In conclusion, combinations of imipenem, cefepime and ceftazidime with avibactam may present a promising therapeutic strategy to treat infections due to K. pneumoniae with OXA-48 enzyme as well as K. pneumoniae and E. coli with CTX-M-15 enzyme. (C) 2011 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.