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2021 ECCMID | 00656 in Vitro Activities of Ceftazidime-Avibactam and Comparator Agents Against Enterobacterales

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IHMA In Vitro Activities of Ceftazidime-avibactam and Comparator Agents against Enterobacterales and 2122 Palmer Drive 00656 Schaumburg, IL 60173 USA Pseudomonas aeruginosa from Israel Collected Through the ATLAS Global Surveillance Program 2013-2019 www.ihma.com M. Hackel1, M. Wise1, G. Stone2, D. Sahm1 1IHMA, Inc., Schaumburg IL, USA, 2Pfizer Inc., Groton, CT USA Introduction Results Results Summary Avibactam (AVI) is a non-β- Table 1 Distribution of 2,956 Enterobacterales from Israel by species Table 2. In vitro activity of ceftazidime-avibactam and comparators agents Figure 2. Ceftazidime and ceftazidime-avibactam MIC distribution against 29 . Ceftazidime-avibactam exhibited a potent lactam, β-lactamase inhibitor against Enterobacterales and P. aeruginosa from Israel, 2013-2019 non-MBL carbapenem-nonsusceptible (CRE) Enterobacterales from Israel, antimicrobial activity higher than all Organism N % of Total mg/L that can restore the activity of Organism Group (N) %S 2013-2019 comparator agents against all Citrobacter amalonaticus 2 0.1% MIC90 MIC50 Range ceftazidime (CAZ) against Enterobacterales (2956) 20 Enterobacterales from Israel (MIC90, 0.5 Citrobacter braakii 5 0.2% Ceftazidime-avibactam 99.8 0.5 0.12 ≤0.015 - > 128 Ceftazidime Ceftazidime-avibactam organisms that possess Class 18 mg/L; 99.8% susceptible). Citrobacter freundii 96 3.2% Ceftazidime 70.1 64 0.25 ≤0.015 - > 128 A, C, and some Class D β- Cefepime 71.8 > 16 ≤0.12 ≤0.12 - > 16 16 . Susceptibility to ceftazidime-avibactam lactmase enzymes. This study Citrobacter gillenii 1 <0.1% Meropenem 98.8 0.12 ≤0.06 ≤0.06 - > 8 increased to 100% for the Enterobacterales Amikacin 95.4 8 2 ≤0.25 - > 32 14 examined the in vitro activity Citrobacter koseri 123 4.2% when MBL-positive isolates were removed Colistin (n=2544)* 82.2 > 8 0.5 ≤0.06 - > 8 12 of CAZ-AVI and comparators Citrobacter murliniae 1 <0.1% Piperacillin-tazobactam 80.4 32 2 ≤0.12 - > 64 from analysis. against Enterobacterales and Enterobacterales, MBL-negative (2948) N 10 . 100% of MBL-negative, meropenem- Citrobacter sedlakii 4 0.1% Ceftazidime-avibactam 100 0.5 0.12 ≤0.015 - 8 Pseudomonas aeruginosa Ceftazidime 70.3 64 0.25 ≤0.015 - > 128 8 nonsusceptible Enterobacterales isolates Enterobacter asburiae 13 0.4% Cefepime 72.0 > 16 ≤0.12 ≤0.12 - > 16 collected in Israel through the 6 (CRE) were susceptible to ceftazidime- Enterobacter cloacae 211 7.1% Meropenem 99.0 0.12 ≤0.06 ≤0.06 - > 8 ATLAS global surveillance Amikacin 95.5 8 2 ≤0.25 - > 32 avibactam (MIC , 4 mg/L). 4 90 program from 2013 to 2019. Enterobacter cloacae complex 1 <0.1% Colistin (n=2536)* 82.3 > 8 0.5 ≤0.06 - > 8 . Similarly, 100% of KPC-producing Piperacillin-tazobactam 80.5 32 2 ≤0.12 - > 64 2 Enterobacter kobei 4 0.1% CRE, MBL-negative (29) Enterobacterales isolates were susceptible to Ceftazidime-avibactam 100 4 1 0.12 - 8 0 Enterobacter ludwigii 1 <0.1% ceftazidime-avibactam (MIC90, 4 mg/L). Ceftazidime 0 > 128 > 128 16 - > 128 0.12 0.25 0.5 1 2 4 8 16 32 64 > 64 Enterobacter sp. 5 0.2% Cefepime 6.9 > 16 > 16 0.25 - > 16 . Ceftazidime-avibactam also showed greater Meropenem 0 > 8 > 8 4 - > 8 MIC (mg/L) activity than all comparators against P. Escherichia coli 877 29.7% Amikacin 44.8 > 32 16 0.5 - > 32 Dashed line represents the EUCAST 2020 breakpoint of 8 mg/L for ceftazidime-avibactam aeruginosa isolates from Israel (MIC , 4 Klebsiella aerogenes 147 5.0% Colistin (n=23) * 91.3 2 0.5 0.12 - > 8 90 Piperacillin-tazobactam 0 > 64 > 64 32 - > 64 Figure 3. Ceftazidime and ceftazidime-avibactam MIC distribution against 21 mg/L; 98.5% susceptible). Against only the Klebsiella oxytoca 152 5.1% Enterobacterales, KPC-positive (21) Ceftazidime-avibactam 100 4 1 0.12 - 4 KPC-positive Enterobacterales from Israel, 2013-2019 meropenem non-susceptible P. aeruginosa Klebsiella pneumoniae 809 27.4% Ceftazidime 0 > 128 > 128 16 - > 128 16 subset, the activity remained very good as Klebsiella variicola 9 0.3% Cefepime 0 > 16 > 16 0.25 - > 16 Ceftazidime Ceftazidime-avibactam 94.5% of the isolates were susceptible with Methods Meropenem 0 > 8 > 8 4 - > 8 14 Morganella morganii 84 2.8% Amikacin 38.1 > 32 32 0.5 - > 32 only the last resort agent, colistin, exhibiting A total of 2,956 non-duplicate, Colistin (n=16)* 87.5 4 0.5 0.12 - > 8 Pluralibacter gergoviae 1 <0.1% Piperacillin-tazobactam 0 > 64 >64 > 64 - > 64 12 higher activity (96.3% susceptible). clinically isolated Entero- Proteus hauseri 14 0.5% Escherichia coli (877) bacterales and 820 P. Ceftazidime-avibactam 100 0.25 0.12 ≤0.015 - 8 10 Proteus mirabilis 156 5.3% Ceftazidime 72.1 32 0.25 ≤0.015 - > 128 aeruginosa were collected Cefepime 73.9 > 16 ≤0.12 ≤0.12 - > 16 N 8 from five sites in Israel during Proteus penneri 3 0.1% Meropenem 99.7 0.06 0.03 ≤0.06 - > 8 Amikacin 95.4 8 2 0.5 - > 32 Conclusions 2013 to 2019. Susceptibility Proteus vulgaris 68 2.3% 6 Colistin (n=734)* 99.7 1 0.25 ≤0.06 - > 8 Ceftazidime-avibactam demonstrated potent in testing was done using broth Providencia rettgeri 10 0.3% Piperacillin-tazobactam 86.9 16 2 ≤0.25 - > 64 4 Klebsiella pneumoniae (809) vitro activity against Enterobacterales and P. microdilution according to Providencia stuartii 64 2.2% Ceftazidime-avibactam 100 0.5 0.12 ≤0.015 - 8 2 aeruginosa collected in Israel. For infections CLSI guidelines (1) and Raoultella ornithinolytica 3 0.1% Ceftazidime 49.7 128 2 ≤0.015 - > 128 Cefepime 50.6 > 16 1 ≤0.12 - > 16 caused by P. aeruginosa and Enterobacterales interpreted using EUCAST 0 Serratia marcescens 92 3.1% Meropenem 97.4 0.12 ≤0.06 ≤0.06 - > 8 that are MBL-negative, ceftazidime-avibactam 2021 breakpoints (2). CAZ-AVI Amikacin 93.2 8 1 0.5 - > 32 0.12 0.25 0.5 1 2 4 8 16 32 64 > 64 Total 2956 100% Colistin (n=706)* 99.2 1 0.5 ≤0.06 - > 8 offers a compelling therapeutic alternative to was tested with a fixed MIC (mg/L) Piperacillin-tazobactam 61.9 > 64 8 0.5 - > 64 other agents like colistin and meropenem. concentration of 4 mg/L AVI. Enterobacter spp. (235) Dashed line represents the EUCAST 2020 breakpoint of 8 mg/L for ceftazidime-avibactam Organisms non-susceptible to Figure 1. Ceftazidime and ceftazidime-avibactam MIC distribution against Ceftazidime-avibactam 98.7 1 0.25 ≤0.015 - 64 2,956 Enterobacterales from Israel, 2013-2019 Ceftazidime 66.0 128 0.5 0.06 - > 128 Figure 4. Ceftazidime and ceftazidime-avibactam MIC distribution against 820 meropenem were screened Cefepime 74.0 16 ≤0.12 ≤0.12 - > 16 for acquired beta-lactamases 1200 Meropenem 97.5 0.12 ≤0.06 ≤0.06 - > 8 P. aeruginosa from Israel, 2013-2019 Amikacin 98.7 4 1 0.5 - > 32 by PCR, followed by Sanger Ceftazidime Ceftazidime-avibactam 450 Colistin (n=210)* 93.3 1 0.5 ≤0.06 - > 8 Ceftazidime Ceftazidime-avibactam sequencing (3). 1000 Piperacillin-tazobactam 71.1 > 64 2 ≤0.25 - > 64 400 References Pseudomonas aeruginosa (820) 1. CLSI. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow aerobically. 11th ed. CLSI standard M07. Wayne, PA: Clinical 800 Ceftazidime-avibactam 98.5 4 2 ≤0.015 - 32 350 Ceftazidime** 83.8 32 2 0.12 - > 128 and Laboratory Standards Institute; 2018. 2. The European Committee on Antimicrobial Susceptibility Testing. Cefepime** 86.0 16 2 ≤0.12 - > 32 300 Breakpoint tables for interpretation of MICs and zone diameters. Version Meropenem 82.2 8 0.5 0.015 - > 8 600 11.0, 2021. http://www.eucast.org. N Amikacin 97.4 8 4 ≤0.25 - > 64 250 N 3. Lob SH, Kazmierczak KM, Badal RE, Hackel MA, Bouchillon SK, Colistin (n=760)* 97.9 2 1 0.12 - 4 200 Biedenbach DJ, Sahm, DF. 2015. Trends in susceptibility of Escherichia coli 400 Piperacillin-tazobactam** 78.5 > 128 8 ≤0.12 - > 128 from intra-abdominal infections to ertapenem and comparators in the United Pseudomonas aeruginosa, MEM-NS (146) 150 States according to data from the SMART program, 2009 to 2013. Ceftazidime-avibactam 94.5 8 4 1 - 32 Antimicrob Agents Chemother 59:3606-3610. 200 Ceftazidime** 63.0 128 8 1 - > 128 100 Cefepime** 60.3 32 8 1 - > 32 0 Meropenem 0 > 8 8 4 - > 8 50 Amikacin 91.1 16 4 0.5 - > 64 0.015 0.03 0.06 0.12 0.25 0.5 1 2 4 8 16 32 64 > 64 Colistin (n=134)* 96.3 2 1 0.25 - 4 0 MIC (mg/L) Piperacillin-tazobactam** 50.7 > 128 16 4 - > 128 0.015 0.03 0.06 0.12 0.25 0.5 1 2 4 8 16 32 64 > 64 Disclosures %S, percent susceptible defined using EUCAST 2021 breakpoints; CRE, carbapenem resistant This study was sponsored by Pfizer. IHMA received financial support from Enterobacterales based on meropenem nonsusceptibility (MIC ≥4mg/L); MEM, meropenem; NS, non- MIC (mg/L) Pfizer in connection with the study and the development of this poster. MW, Dashed line represents the EUCAST 2020 breakpoint of 8 mg/L for ceftazidime-avibactam susceptible. MBL, metallo-β-lactamase MH, and DS are employees of IHMA. GS is an employee of Pfizer. *colistin was not tested in 2013 Dashed line represents the EUCAST 2020 breakpoint of 8 mg/L for ceftazidime-avibactam **% “susceptible, increased exposure” is given Presented at ECCMID 2021, July 9-12, 2021 Online.
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    IHMA, Inc. In Vitro Activities of Aztreonam-avibactam and Ceftazidime-avibactam Against Less Commonly Encountered Gram-Negative 2122 Palmer Drive P1155 Schaumburg, IL 60173 USA Bacteria Collected During the ATLAS Global Surveillance Program 2012-2017 www.ihma.com M. Hackel1, G Stone2, B. deJonge3, D. Sahm1 1IHMA, Inc., Schaumburg IL, USA 2Pfizer Inc., Cambridge, MA USA 3Pfizer Inc., Cambridge MA, USA Introduction Results Results While antimicrobial susceptibility Table 1. Less commonly isolated gram-negative species Table 2. In vitro activity of ceftazidime-avibactam, aztreonam-avibactam and comparators against less commonly encountered gram-negative bacteria collected in 2012-2017 . ATM-AVI and CAZ-AVI showed MIC90 values from the ATLAS Global Surveillance Program 2012-2017 AZT-AVI CAZ-AVI CST* MEM TGC TZP LVX profiles have been well described in Organism N ranging from ≤0.015 to 0.5 mg/L and 0.06 to 1 %S MIC Range %S MIC Range %S MIC Range %S MIC Range %S MIC Range %S MIC Range %S MIC Range more common members of the 90 90 90 90 90 90 90 mg/L, respectively, against members of the Organism N Percent of total Acinetobacter nosocomialis 183 na 64 2 - >128 na 32 1 - >128 96.8 2 0.25 - >8 79.8 > 8 0.015 - >8 na 1 0.06 - 4 na > 128 ≤0.25 - >128 76.5 >4 0.06 - >8 Enterobacterales, notably Escherichia Enterobacterales (Table 2). 98.3% were coli and Klebsiella pneumoniae, and in Acinetobacter nosocomialis 183 5.1 Acinetobacter pittii 402 na 64 2 - >128 na 16 0.5 - >128 99.2 2 0.12 - 4 92.3 1 ≤0.06 - >8 na 1 0.03 - >8 na 64 ≤0.25 - >128 88.6 2 0.06 - >8 Citrobacter spp.
  • Citrobacter Braakii

    Citrobacter Braakii

    & M cal ed ni ic li a l C G f e Trivedi et al., J Clin Med Genom 2015, 3:1 o n l o a m n r DOI: 10.4172/2472-128X.1000129 i u c s o Journal of Clinical & Medical Genomics J ISSN: 2472-128X ResearchResearch Article Article OpenOpen Access Access Phenotyping and 16S rDNA Analysis after Biofield Treatment on Citrobacter braakii: A Urinary Pathogen Mahendra Kumar Trivedi1, Alice Branton1, Dahryn Trivedi1, Gopal Nayak1, Sambhu Charan Mondal2 and Snehasis Jana2* 1Trivedi Global Inc., Eastern Avenue Suite A-969, Henderson, NV, USA 2Trivedi Science Research Laboratory Pvt. Ltd., Chinar Fortune City, Hoshangabad Rd., Madhya Pradesh, India Abstract Citrobacter braakii (C. braakii) is widespread in nature, mainly found in human urinary tract. The current study was attempted to investigate the effect of Mr. Trivedi’s biofield treatment on C. braakii in lyophilized as well as revived state for antimicrobial susceptibility pattern, biochemical characteristics, and biotype number. Lyophilized vial of ATCC strain of C. braakii was divided into two parts, Group (Gr.) I: control and Gr. II: treated. Gr. II was further subdivided into two parts, Gr. IIA and Gr. IIB. Gr. IIA was analysed on day 10 while Gr. IIB was stored and analysed on day 159 (Study I). After retreatment on day 159, the sample (Study II) was divided into three separate tubes. First, second and third tube was analysed on day 5, 10 and 15, respectively. All experimental parameters were studied using automated MicroScan Walk-Away® system. The 16S rDNA sequencing of lyophilized treated sample was carried out to correlate the phylogenetic relationship of C.
  • The LOUISIANA ANTIBIOGRAM Louisiana Antibiotic Resistance 2014

    The LOUISIANA ANTIBIOGRAM Louisiana Antibiotic Resistance 2014

    The LOUISIANA ANTIBIOGRAM Louisiana Antibiotic Trends in Antibiotic Resistance Resistance 2014 in Louisiana 2008 Zahidul Islam MBBS, MPH, Raoult C Ratard MD MPH Contributors to this report: Lauren Kleamenakis MPH, Anup Subedee MD MPH and Raoult Ratard MD MPH. This report covers bacteria causing severe human infections and the antibiotics used to treat those infections. Resistance to other antimicrobials (antivirals, antifungals and anti-parasitic drugs) are not included for lack of systematic reporting and collection of comprehensive data. Contents 1-Introduction ............................................................................................................................................... 3 1.1-Bacterial resistance to antibiotics is a major threat to human health .................................................. 3 1.2-Tracking resistance patterns is a major action in the fight against antibiotic resistance ..................... 3 2-Methods ..................................................................................................................................................... 3 2.1-Active surveillance .............................................................................................................................. 3 2.2-Antibiogram collection ....................................................................................................................... 3 2.3-Analysis ..............................................................................................................................................
  • Pocket Guide to Clinical Microbiology

    Pocket Guide to Clinical Microbiology

    4TH EDITION Pocket Guide to Clinical Microbiology Christopher D. Doern 4TH EDITION POCKET GUIDE TO Clinical Microbiology 4TH EDITION POCKET GUIDE TO Clinical Microbiology Christopher D. Doern, PhD, D(ABMM) Assistant Professor, Pathology Director of Clinical Microbiology Virginia Commonwealth University Health System Medical College of Virginia Campus Washington, DC Copyright © 2018 Amer i can Society for Microbiology. All rights re served. No part of this publi ca tion may be re pro duced or trans mit ted in whole or in part or re used in any form or by any means, elec tronic or me chan i cal, in clud ing pho to copy ing and re cord ing, or by any in for ma tion stor age and re trieval sys tem, with out per mis sion in writ ing from the pub lish er. Disclaimer: To the best of the pub lish er’s knowl edge, this pub li ca tion pro­ vi des in for ma tion con cern ing the sub ject mat ter cov ered that is ac cu rate as of the date of pub li ca tion. The pub lisher is not pro vid ing le gal, med i cal, or other pro fes sional ser vices. Any ref er ence herein to any spe cific com mer cial prod ucts, pro ce dures, or ser vices by trade name, trade mark, man u fac turer, or oth er wise does not con sti tute or im ply en dorse ment, rec om men da tion, or fa vored sta tus by the Ameri can Society for Microbiology (ASM).