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Changing Characteristics and In Vitro Susceptibility to Ceftazidime/Avibactam of Bloodstream Extensively Drug-Resistant Klebsiella pneumoniae from a Greek Intensive Care Unit.
Microb Drug Resist. 2020 Jan; 26(1):28-37.MD

Abstract

During 2014-2016, a total of 248 carbapenem-resistant Klebsiella pneumoniae (CARB-R Kp) were recovered in a Greek intensive care unit (ICU), the colistin resistance (COL-R) rates among CARB-R Kp from bloodstream infections (BSIs) were determined, and molecular characterization and the in vitro susceptibility of CARB-R+COL-R Kp to ceftazidime/avibactam were performed. The majority of CARB-R Kp from BSIs (n = 53) were OXA-48 (43.4%) and KPC (33.9%) producers, but no statistically significant differences were observed for the clinical characteristics of ICU patients affected by OXA-48 and other carbapenemase-producing K. pneumoniae. CARB-R+COL-R Kp (n = 28) represented 52.8% of 53 CARB-R Kp recovered from BSIs. The increase in the COL-R rates from 2014 to 2015 was mainly associated with the diffusion of extensively drug-resistant (XDR) OXA-48-co-producing CTX-M-15-like K. pneumoniae, assigned to multilocus-sequence typing ST101, possessing alterations in the mgrB loci. Ceftazidime/avibactam was active against all OXA-48 and KPC producers. Thus, the spread of XDR Kp possessing different types of carbapenemases further complicates the infection control strategies for the management of XDR Kp, whereas ceftazidime/avibactam may be a reasonable alternative to colistin for the treatment of XDR Kp in settings with low prevalence of metallo-β lactamase-producing K. pneumoniae.

Authors+Show Affiliations

Department of Microbiology, Konstantopouleio-Patission, General Hospital of N. Ionias, Athens, Greece.Intensive Care Unit, Konstantopouleio-Patission, General Hospital of N. Ionias, Athens, Greece.Department of Microbiology, Konstantopouleio-Patission, General Hospital of N. Ionias, Athens, Greece.Department of Microbiology, Konstantopouleio-Patission, General Hospital of N. Ionias, Athens, Greece.Department of Microbiology, Konstantopouleio-Patission, General Hospital of N. Ionias, Athens, Greece.Intensive Care Unit, Konstantopouleio-Patission, General Hospital of N. Ionias, Athens, Greece.Intensive Care Unit, Konstantopouleio-Patission, General Hospital of N. Ionias, Athens, Greece.Department of Microbiology, Konstantopouleio-Patission, General Hospital of N. Ionias, Athens, Greece.Department of Microbiology, Konstantopouleio-Patission, General Hospital of N. Ionias, Athens, Greece.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31386596

Citation

Mavroidi, Angeliki, et al. "Changing Characteristics and in Vitro Susceptibility to Ceftazidime/Avibactam of Bloodstream Extensively Drug-Resistant Klebsiella Pneumoniae From a Greek Intensive Care Unit." Microbial Drug Resistance (Larchmont, N.Y.), vol. 26, no. 1, 2020, pp. 28-37.
Mavroidi A, Katsiari M, Likousi S, et al. Changing Characteristics and In Vitro Susceptibility to Ceftazidime/Avibactam of Bloodstream Extensively Drug-Resistant Klebsiella pneumoniae from a Greek Intensive Care Unit. Microb Drug Resist. 2020;26(1):28-37.
Mavroidi, A., Katsiari, M., Likousi, S., Palla, E., Roussou, Z., Nikolaou, C., Mathas, C., Merkouri, E., & Platsouka, E. D. (2020). Changing Characteristics and In Vitro Susceptibility to Ceftazidime/Avibactam of Bloodstream Extensively Drug-Resistant Klebsiella pneumoniae from a Greek Intensive Care Unit. Microbial Drug Resistance (Larchmont, N.Y.), 26(1), 28-37. https://doi.org/10.1089/mdr.2019.0090
Mavroidi A, et al. Changing Characteristics and in Vitro Susceptibility to Ceftazidime/Avibactam of Bloodstream Extensively Drug-Resistant Klebsiella Pneumoniae From a Greek Intensive Care Unit. Microb Drug Resist. 2020;26(1):28-37. PubMed PMID: 31386596.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changing Characteristics and In Vitro Susceptibility to Ceftazidime/Avibactam of Bloodstream Extensively Drug-Resistant Klebsiella pneumoniae from a Greek Intensive Care Unit. AU - Mavroidi,Angeliki, AU - Katsiari,Maria, AU - Likousi,Sofia, AU - Palla,Eleftheria, AU - Roussou,Zoi, AU - Nikolaou,Charikleia, AU - Mathas,Christos, AU - Merkouri,Eleni, AU - Platsouka,Evangelia D, Y1 - 2019/08/06/ PY - 2019/8/7/pubmed PY - 2020/11/11/medline PY - 2019/8/7/entrez KW - Klebsiella pneumoniae KW - beta lactamases KW - ceftazidime/avibactam KW - epidemiology KW - molecular characterization SP - 28 EP - 37 JF - Microbial drug resistance (Larchmont, N.Y.) JO - Microb Drug Resist VL - 26 IS - 1 N2 - During 2014-2016, a total of 248 carbapenem-resistant Klebsiella pneumoniae (CARB-R Kp) were recovered in a Greek intensive care unit (ICU), the colistin resistance (COL-R) rates among CARB-R Kp from bloodstream infections (BSIs) were determined, and molecular characterization and the in vitro susceptibility of CARB-R+COL-R Kp to ceftazidime/avibactam were performed. The majority of CARB-R Kp from BSIs (n = 53) were OXA-48 (43.4%) and KPC (33.9%) producers, but no statistically significant differences were observed for the clinical characteristics of ICU patients affected by OXA-48 and other carbapenemase-producing K. pneumoniae. CARB-R+COL-R Kp (n = 28) represented 52.8% of 53 CARB-R Kp recovered from BSIs. The increase in the COL-R rates from 2014 to 2015 was mainly associated with the diffusion of extensively drug-resistant (XDR) OXA-48-co-producing CTX-M-15-like K. pneumoniae, assigned to multilocus-sequence typing ST101, possessing alterations in the mgrB loci. Ceftazidime/avibactam was active against all OXA-48 and KPC producers. Thus, the spread of XDR Kp possessing different types of carbapenemases further complicates the infection control strategies for the management of XDR Kp, whereas ceftazidime/avibactam may be a reasonable alternative to colistin for the treatment of XDR Kp in settings with low prevalence of metallo-β lactamase-producing K. pneumoniae. SN - 1931-8448 UR - https://www.unboundmedicine.com/medline/citation/31386596/Changing_Characteristics_and_In_Vitro_Susceptibility_to_Ceftazidime/Avibactam_of_Bloodstream_Extensively_Drug_Resistant_Klebsiella_pneumoniae_from_a_Greek_Intensive_Care_Unit_ L2 - https://www.liebertpub.com/doi/10.1089/mdr.2019.0090?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -