German Multicenter Study Analyzing Antimicrobial Activity of Ceftazidime-Avibactam of Clinical Meropenem-Resistant <i>Pseudomonas aeruginosa</i> Isolates Using a Commercially Available Broth Microdilution Assay
Jana Manzke,
Raphael Stauf,
Bernd Neumann,
Ernst Molitor,
Gunnar Hischebeth,
Michaela Simon,
Jonathan Jantsch,
Jürgen Rödel,
Sören L. Becker,
Alexander Halfmann,
Thomas A. Wichelhaus,
Michael Hogardt,
Annerose Serr,
Christina Hess,
Andreas F. Wendel,
Ekkehard Siegel,
Holger Rohde,
Stefan Zimmermann,
Jörg Steinmann
Affiliations
Jana Manzke
Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, 90419 Nuremberg, Germany
Raphael Stauf
Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, 90419 Nuremberg, Germany
Bernd Neumann
Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, 90419 Nuremberg, Germany
Ernst Molitor
Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, 53127 Bonn, Germany
Gunnar Hischebeth
Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, 53127 Bonn, Germany
Michaela Simon
Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, 93053 Regensburg, Germany
Jonathan Jantsch
Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, 93053 Regensburg, Germany
Jürgen Rödel
Institute of Medical Microbiology, Jena University Hospital, 07743 Jena, Germany
Sören L. Becker
Institute of Medical Microbiology and Hygiene, Saarland University, 66421 Homburg, Germany
Alexander Halfmann
Institute of Medical Microbiology and Hygiene, Saarland University, 66421 Homburg, Germany
Thomas A. Wichelhaus
German National Consiliary Laboratory on Cystic Fibrosis Bacteriology, Institute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany
Michael Hogardt
German National Consiliary Laboratory on Cystic Fibrosis Bacteriology, Institute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany
Annerose Serr
Department for Medical Microbiology and Hygiene, University Hospital Freiburg, 79106 Freiburg, Germany
Christina Hess
Department for Medical Microbiology and Hygiene, University Hospital Freiburg, 79106 Freiburg, Germany
Andreas F. Wendel
Institute of Hygiene, Cologne Merheim Medical Centre, University Hospital of Witten/Herdecke, 51058 Cologne, Germany
Ekkehard Siegel
Institute for Medical Microbiology, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany
Holger Rohde
Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
Stefan Zimmermann
Department of Infectious Diseases, University Hospital Heidelberg, 69120 Heidelberg, Germany
Jörg Steinmann
Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, 90419 Nuremberg, Germany
Multidrug resistance is an emerging healthcare issue, especially concerning Pseudomonas aeruginosa. In this multicenter study, P. aeruginosa isolates with resistance against meropenem detected by routine methods were collected and tested for carbapenemase production and susceptibility against ceftazidime-avibactam. Meropenem-resistant isolates of P. aeruginosa from various clinical materials were collected at 11 tertiary care hospitals in Germany from 2017–2019. Minimum inhibitory concentrations (MICs) were determined via microdilution plates (MICRONAUT-S) of ceftazidime-avibactam and meropenem at each center. Detection of the presence of carbapenemases was performed by PCR or immunochromatography. For meropenem-resistant isolates (n = 448), the MIC range of ceftazidime-avibactam was 0.25–128 mg/L, MIC90 was 128 mg/L and MIC50 was 16 mg/L. According to EUCAST clinical breakpoints, 213 of all meropenem-resistant P. aeruginosa isolates were categorized as susceptible (47.5%) to ceftazidime-avibactam. Metallo-β-lactamases (MBL) could be detected in 122 isolates (27.3%). The MIC range of ceftazidime-avibactam in MBL-positive isolates was 4–128 mg/L, MIC90 was >128 mg/L and MIC50 was 32 mg/L. There was strong variation in the prevalence of MBL-positive isolates among centers. Our in vitro results support ceftazidime-avibactam as a treatment option against infections caused by meropenem-resistant, MBL-negative P. aeruginosa.
