Journal
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
Volume 53, Issue 5, Pages 682-688Publisher
ELSEVIER
DOI: 10.1016/j.ijantimicag.2019.02.004
Keywords
Ceftolozane/tazobactam; Intensive care unit; Spain; Intra-abdominal infection; Urinary tract infection
Funding
- MSD Spain
- Plan Nacional de I + D + i 2013-2016
- Instituto de Salud Carlos III, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Economia, Industria y Competitividad, Spanish Network for Research in Infectious Diseases [RD16/0016/0001, RD16/0016/0004, RD16/0016/0006, RD16/0016/0007, RD16/0016/0010, REIPI RD16/0016/0011]
- European Development Regional Fund 'A way to achieve Europe' (ERDF), Operative program Intelligent Growth 2014-2020
- Instituto de Salud Carlos III, Spain [Rio Hortega program] [CM17/00033]
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Patients in intensive care units (ICUs) present a high risk of developing an infection caused by multidrug-resistant bacteria. Consequently, new antimicrobials and combinations are required. In this study, the activity of ceftolozane/tazobactam (C/T) was evaluated against Enterobacterales (n = 400) and Pseudomonas aeruginosa (n = 80) clinical isolates collected from patients in Spanish ICUs with complicated urinary tract infections (cUTI) and complicated intra-abdominal infections (cIAI). Overall susceptibility to C/T in P. aeruginosa isolates by infection type was 95.7% in cUTI (MIC 50/90, 1/4 mg/L) and 85.3% in cIAI (MIC 50/90, 1/64 mg/L). Activity against P. aeruginosa was maintained regardless of its resistance pattern, confirming that C/T is one of the best antipseudomonal agents along with colistin and amikacin. Susceptibility to C/T in Enterobacterales by infection type was 79.5/81.9% and 89.3/92.3% (EUCAST/CLSI) in cIAI and cUTI isolates, respectively. Activity was excellent against wild-type organisms, with 100% susceptible and inhibited at MIC = 1 mg/L. Nevertheless, C/T susceptibility decreased against extended-spectrum beta-lactamase (ESBL)-producing isolates: Escherichia coli (80.4/84.8% susceptible by EUCAST/CLSI) and Klebsiella pneumoniae (59.1/77.3% susceptible by EUCAST/CLSI). No activity of C/T was observed in carbapenemase-producing isolates. The in vitro activity of C/T observed in this surveillance study suggests that this agent can be considered as a therapeutic option for cUTI and cIAI due to Enterobacterales and P. aeruginosa in ICU patients, particularly when carbapenemase-producing isolates are not involved. (C) 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.
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