Ceftazidim-avibactam susceptibility of carbapenemase producing enterobacterales in an OXA-48 endemic area

Background: Carbapenem-resistant Enterobacterales (CRE) are included in the critical priority pathogens by WHO. OXA-48 is the predominating carbapenemase in Türkiye, in where carbapenem resistance rates are high, particularly in Klebsiella pneumoniae isolates. Ceftazidime-Avibactam (CAZ-AVI) has bee...

Full description

Saved in:
Bibliographic Details
Main Authors: Şevval Arduç Tok, Ayşe Barış, Leyla Genç, Hanife Tutan, Elif Aktaş
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Global Antimicrobial Resistance
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2213716524002807
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846106930959876096
author Şevval Arduç Tok
Ayşe Barış
Leyla Genç
Hanife Tutan
Elif Aktaş
author_facet Şevval Arduç Tok
Ayşe Barış
Leyla Genç
Hanife Tutan
Elif Aktaş
author_sort Şevval Arduç Tok
collection DOAJ
description Background: Carbapenem-resistant Enterobacterales (CRE) are included in the critical priority pathogens by WHO. OXA-48 is the predominating carbapenemase in Türkiye, in where carbapenem resistance rates are high, particularly in Klebsiella pneumoniae isolates. Ceftazidime-Avibactam (CAZ-AVI) has been used successfully in CRE infections in recent years, but resistance is reported to be on the rise. Aim: To evaluate the susceptibility to CAZ-AVI in CRE isolates and association of CAZ-AVI resistance and carbapenemase genes. Methods: CRE isolates from various clinical samples between January 2022 and June 2024 were included in the study. The isolates were identified by VITEK-MS(bioMerieux, France) system. Antibiotic susceptibilities were determined by VITEK COMPACT 2(BioMerieux, France) and CAZ-AVI susceptibility was evaluated by disk diffusion method(Oxoid, Thermo Fisher Scientific, Canada) according to EUCAST criteria. Carbapenemase genes were investigated in 324 representative isolates using Biospeedy Carbapenem-Resistance qPCR kit(Bioeksen, Türkiye). Results: The study included 429 CRE isolates. The distribution of CAZ-AVI susceptibility of CRE isolates according to sample type and clinics is shown in Table 1 and Table 2. CAZ-AVI susceptibility of isolates according to carbapenemase genes is presented in Table 3. In total, CAZ-AVI susceptibility of CRE isolates was 76%, while it was 99.5% in non-metallo-beta-lactamase (MBL) producers and 100% in only OXA-48-like producers. Conclusıons: Despite the increasing resistance in CRE isolates, CAZ-AVI is still a good option for treatment. CAZ-AVI was found to be highly effective particularly in isolates with non-MBL carbapenemase genes. Early detection of carbapenemase type is important in predicting CAZ-AVI susceptibility.
format Article
id doaj-art-7b7d351ae5d34fd39f577bb251646b83
institution Kabale University
issn 2213-7165
language English
publishDate 2024-12-01
publisher Elsevier
record_format Article
series Journal of Global Antimicrobial Resistance
spelling doaj-art-7b7d351ae5d34fd39f577bb251646b832024-12-27T04:08:29ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-013933Ceftazidim-avibactam susceptibility of carbapenemase producing enterobacterales in an OXA-48 endemic areaŞevval Arduç Tok0Ayşe Barış1Leyla Genç2Hanife Tutan3Elif Aktaş4University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Department of Medical MicrobiologyUniversity of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Department of Medical MicrobiologyUniversity of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Department of Medical MicrobiologyUniversity of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Department of Medical MicrobiologyUniversity of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Department of Medical MicrobiologyBackground: Carbapenem-resistant Enterobacterales (CRE) are included in the critical priority pathogens by WHO. OXA-48 is the predominating carbapenemase in Türkiye, in where carbapenem resistance rates are high, particularly in Klebsiella pneumoniae isolates. Ceftazidime-Avibactam (CAZ-AVI) has been used successfully in CRE infections in recent years, but resistance is reported to be on the rise. Aim: To evaluate the susceptibility to CAZ-AVI in CRE isolates and association of CAZ-AVI resistance and carbapenemase genes. Methods: CRE isolates from various clinical samples between January 2022 and June 2024 were included in the study. The isolates were identified by VITEK-MS(bioMerieux, France) system. Antibiotic susceptibilities were determined by VITEK COMPACT 2(BioMerieux, France) and CAZ-AVI susceptibility was evaluated by disk diffusion method(Oxoid, Thermo Fisher Scientific, Canada) according to EUCAST criteria. Carbapenemase genes were investigated in 324 representative isolates using Biospeedy Carbapenem-Resistance qPCR kit(Bioeksen, Türkiye). Results: The study included 429 CRE isolates. The distribution of CAZ-AVI susceptibility of CRE isolates according to sample type and clinics is shown in Table 1 and Table 2. CAZ-AVI susceptibility of isolates according to carbapenemase genes is presented in Table 3. In total, CAZ-AVI susceptibility of CRE isolates was 76%, while it was 99.5% in non-metallo-beta-lactamase (MBL) producers and 100% in only OXA-48-like producers. Conclusıons: Despite the increasing resistance in CRE isolates, CAZ-AVI is still a good option for treatment. CAZ-AVI was found to be highly effective particularly in isolates with non-MBL carbapenemase genes. Early detection of carbapenemase type is important in predicting CAZ-AVI susceptibility.http://www.sciencedirect.com/science/article/pii/S2213716524002807ceftazidime-avibactamcarbapenem resistance enterobacteralescarbapenemase genesoxa-48
spellingShingle Şevval Arduç Tok
Ayşe Barış
Leyla Genç
Hanife Tutan
Elif Aktaş
Ceftazidim-avibactam susceptibility of carbapenemase producing enterobacterales in an OXA-48 endemic area
Journal of Global Antimicrobial Resistance
ceftazidime-avibactam
carbapenem resistance enterobacterales
carbapenemase genes
oxa-48
title Ceftazidim-avibactam susceptibility of carbapenemase producing enterobacterales in an OXA-48 endemic area
title_full Ceftazidim-avibactam susceptibility of carbapenemase producing enterobacterales in an OXA-48 endemic area
title_fullStr Ceftazidim-avibactam susceptibility of carbapenemase producing enterobacterales in an OXA-48 endemic area
title_full_unstemmed Ceftazidim-avibactam susceptibility of carbapenemase producing enterobacterales in an OXA-48 endemic area
title_short Ceftazidim-avibactam susceptibility of carbapenemase producing enterobacterales in an OXA-48 endemic area
title_sort ceftazidim avibactam susceptibility of carbapenemase producing enterobacterales in an oxa 48 endemic area
topic ceftazidime-avibactam
carbapenem resistance enterobacterales
carbapenemase genes
oxa-48
url http://www.sciencedirect.com/science/article/pii/S2213716524002807
work_keys_str_mv AT sevvalarductok ceftazidimavibactamsusceptibilityofcarbapenemaseproducingenterobacteralesinanoxa48endemicarea
AT aysebarıs ceftazidimavibactamsusceptibilityofcarbapenemaseproducingenterobacteralesinanoxa48endemicarea
AT leylagenc ceftazidimavibactamsusceptibilityofcarbapenemaseproducingenterobacteralesinanoxa48endemicarea
AT hanifetutan ceftazidimavibactamsusceptibilityofcarbapenemaseproducingenterobacteralesinanoxa48endemicarea
AT elifaktas ceftazidimavibactamsusceptibilityofcarbapenemaseproducingenterobacteralesinanoxa48endemicarea