Ceftolozane-tazobactam activity against clinical isolates of Pseudomonas aeruginosa from ICU patients with pneumonia: United States, 2015–2018

ABSTRACT: Objectives: To report on the activity of ceftolozane-tazobactam and comparators against Pseudomonas aeruginosa isolates collected from hospitalized patients with pneumonia in US intensive care units (ICUs) between 2015 and 2018. Activity against all P. aeruginosa and common resistant pheno...

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Autores principales:	Michael A. Pfaller, Dee Shortridge, Kelly A. Harris, Mark W. Garrison, C. Andrew DeRyke, Daryl D. DePestel, Pamela A. Moise, Helio S. Sader
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Ceftolozane-tazobactam ICU Ventilator-associated pneumonia Pseudomonas aeruginosa Coresistance Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/cf72f849d8a4498eace2fdbed29e04ca
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spelling	oai:doaj.org-article:cf72f849d8a4498eace2fdbed29e04ca2021-11-30T04:14:26ZCeftolozane-tazobactam activity against clinical isolates of Pseudomonas aeruginosa from ICU patients with pneumonia: United States, 2015–20181201-971210.1016/j.ijid.2021.09.064https://doaj.org/article/cf72f849d8a4498eace2fdbed29e04ca2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1201971221007773https://doaj.org/toc/1201-9712ABSTRACT: Objectives: To report on the activity of ceftolozane-tazobactam and comparators against Pseudomonas aeruginosa isolates collected from hospitalized patients with pneumonia in US intensive care units (ICUs) between 2015 and 2018. Activity against all P. aeruginosa and common resistant phenotypes are described to better inform decision-making and support antimicrobial stewardship efforts.Methods: In total, 781 P. aeruginosa isolates were collected from 28 US hospitals. These isolates were tested for susceptibility to ceftolozane-tazobactam and comparators by Clinical and Laboratory Standards Institute (CLSI) broth microdilution methodology using CLSI (2020) breakpoints. Phenotypes analysed included piperacillin-tazobactam-non-susceptible (NS), cefepime-NS, ceftazidime-NS, meropenem-NS and difficult-to-treat resistance (DTR).Results: Ceftolozane-tazobactam was the most potent agent tested (minimum inhibitory concentration to inhibit 50% and 90% of isolates of 0.5 and 2 mg/L, respectively, inhibiting 97.2% at the susceptible breakpoint of ≤4 mg/L). Traditional first-line antipseudomonal β-lactam antibiotics (piperacillin-tazobactam, cefepime and ceftazidime) demonstrated <33% susceptibility when P. aeruginosa was NS to one or more agent. Although escalation of therapy to meropenem is commonly employed clinically, meropenem susceptibility ranged from 33.6% to 44.9% if P. aeruginosa was NS to any traditional first-line antipseudomonal β-lactam agent. Conversely, ceftolozane-tazobactam remained active against isolates that were NS to other agents, inhibiting 88.4% of isolates NS to piperacillin-tazobactam, 85.0% of isolates NS to cefepime and ceftazidime, and 90.3% of isolates NS to meropenem. Ceftolozane-tazobactam also maintained activity against 73.0% of DTR isolates.Conclusions: Ceftolozane-tazobactam maintained high activity against P. aeruginosa isolated from hospitalized patients with pneumonia in US ICUs, and had the greatest activity against isolates NS to one or more antipseudomonal β-lactams and DTR isolates.Michael A. PfallerDee ShortridgeKelly A. HarrisMark W. GarrisonC. Andrew DeRykeDaryl D. DePestelPamela A. MoiseHelio S. SaderElsevierarticleCeftolozane-tazobactamICUVentilator-associated pneumoniaPseudomonas aeruginosaCoresistanceInfectious and parasitic diseasesRC109-216ENInternational Journal of Infectious Diseases, Vol 112, Iss , Pp 321-326 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ceftolozane-tazobactam ICU Ventilator-associated pneumonia Pseudomonas aeruginosa Coresistance Infectious and parasitic diseases RC109-216
spellingShingle	Ceftolozane-tazobactam ICU Ventilator-associated pneumonia Pseudomonas aeruginosa Coresistance Infectious and parasitic diseases RC109-216 Michael A. Pfaller Dee Shortridge Kelly A. Harris Mark W. Garrison C. Andrew DeRyke Daryl D. DePestel Pamela A. Moise Helio S. Sader Ceftolozane-tazobactam activity against clinical isolates of Pseudomonas aeruginosa from ICU patients with pneumonia: United States, 2015–2018
description	ABSTRACT: Objectives: To report on the activity of ceftolozane-tazobactam and comparators against Pseudomonas aeruginosa isolates collected from hospitalized patients with pneumonia in US intensive care units (ICUs) between 2015 and 2018. Activity against all P. aeruginosa and common resistant phenotypes are described to better inform decision-making and support antimicrobial stewardship efforts.Methods: In total, 781 P. aeruginosa isolates were collected from 28 US hospitals. These isolates were tested for susceptibility to ceftolozane-tazobactam and comparators by Clinical and Laboratory Standards Institute (CLSI) broth microdilution methodology using CLSI (2020) breakpoints. Phenotypes analysed included piperacillin-tazobactam-non-susceptible (NS), cefepime-NS, ceftazidime-NS, meropenem-NS and difficult-to-treat resistance (DTR).Results: Ceftolozane-tazobactam was the most potent agent tested (minimum inhibitory concentration to inhibit 50% and 90% of isolates of 0.5 and 2 mg/L, respectively, inhibiting 97.2% at the susceptible breakpoint of ≤4 mg/L). Traditional first-line antipseudomonal β-lactam antibiotics (piperacillin-tazobactam, cefepime and ceftazidime) demonstrated <33% susceptibility when P. aeruginosa was NS to one or more agent. Although escalation of therapy to meropenem is commonly employed clinically, meropenem susceptibility ranged from 33.6% to 44.9% if P. aeruginosa was NS to any traditional first-line antipseudomonal β-lactam agent. Conversely, ceftolozane-tazobactam remained active against isolates that were NS to other agents, inhibiting 88.4% of isolates NS to piperacillin-tazobactam, 85.0% of isolates NS to cefepime and ceftazidime, and 90.3% of isolates NS to meropenem. Ceftolozane-tazobactam also maintained activity against 73.0% of DTR isolates.Conclusions: Ceftolozane-tazobactam maintained high activity against P. aeruginosa isolated from hospitalized patients with pneumonia in US ICUs, and had the greatest activity against isolates NS to one or more antipseudomonal β-lactams and DTR isolates.
format	article
author	Michael A. Pfaller Dee Shortridge Kelly A. Harris Mark W. Garrison C. Andrew DeRyke Daryl D. DePestel Pamela A. Moise Helio S. Sader
author_facet	Michael A. Pfaller Dee Shortridge Kelly A. Harris Mark W. Garrison C. Andrew DeRyke Daryl D. DePestel Pamela A. Moise Helio S. Sader
author_sort	Michael A. Pfaller
title	Ceftolozane-tazobactam activity against clinical isolates of Pseudomonas aeruginosa from ICU patients with pneumonia: United States, 2015–2018
title_short	Ceftolozane-tazobactam activity against clinical isolates of Pseudomonas aeruginosa from ICU patients with pneumonia: United States, 2015–2018
title_full	Ceftolozane-tazobactam activity against clinical isolates of Pseudomonas aeruginosa from ICU patients with pneumonia: United States, 2015–2018
title_fullStr	Ceftolozane-tazobactam activity against clinical isolates of Pseudomonas aeruginosa from ICU patients with pneumonia: United States, 2015–2018
title_full_unstemmed	Ceftolozane-tazobactam activity against clinical isolates of Pseudomonas aeruginosa from ICU patients with pneumonia: United States, 2015–2018
title_sort	ceftolozane-tazobactam activity against clinical isolates of pseudomonas aeruginosa from icu patients with pneumonia: united states, 2015–2018
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/cf72f849d8a4498eace2fdbed29e04ca
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Ceftolozane-tazobactam activity against clinical isolates of Pseudomonas aeruginosa from ICU patients with pneumonia: United States, 2015–2018

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