Efficacy of ceftazidime-avibactam, meropenem-vaborbactam, and imipenem-relebactam combinations against carbapenemase-producing Enterobacterales in Switzerland

Carbapenemase-producing in Enterobacterales (CPE) represent a critical health concern worldwide, including in Switzerland, leading to very limited therapeutic options. Therefore, our aim was to evaluate the susceptibility to the novel ss-lactam/ss-lactamase inhibitor combinations ceftazidime-avibactam, meropenem-vaborbactam, and imipenem-relebactam of CPE isolates recovered in Switzerland from 2018 to 2020. A total of 150 clinical CPE were studied including mainly Klebsiella pneumoniae (n = 61, 40.3%) and Escherichia coli (n = 53, 35.3%). The distribution of carbapenemases was as follows: KPC-like (32%), OXA-48-like (32%), NDM-like (24%), combinations of carbapenemases (10%), VIM-1 producers (n = 2), and a single IMI-1 producer. Overall, 77% of the strains were susceptible to meropenem-vaborbactam, 63% was susceptible to ceftazidime-avibactam, and 62% susceptible to imipenem-relebactam. Those data may contribute to optimize the choice of first line therapy for treating infections due to CPE.

Automated summary

Carbapenemase-producing Enterobacterales (CPE) are a major health concern globally, with limited therapeutic options in Switzerland. This study evaluated the susceptibility of CPE isolates recovered in Switzerland from 2018 to 2020 to novel β-lactam/β-lactamase inhibitor combinations, including ceftazidime-avibactam, meropenem-vaborbactam, and imipenem-relebactam. The majority of clinical CPE isolates were Klebsiella pneumoniae and Escherichia coli, and the distribution of carbapenemases varied. The study found that meropenem-vaborbactam had the highest susceptibility among the three combinations, followed by ceftazidime-avibactam and imipenem-relebactam. These findings can help optimize first-line therapy for CPE infections.