Ceftolozane/Tazobactam In-Vitro Activity against Clinical Isolates from Complicated Intra-Abdominal Infection Patients in Three Indonesian Referral Hospitals
Anis Karuniawati,
Merry Ambarwulan,
Selvi Nafisa Shahab,
Yefta Moenadjat,
Toar J. M. Lalisang,
Neneng Dewi Kurniati,
Kuntaman,
Vicky Sumarki Budipramana,
Tomy Lesmana,
Iva Puspitasari,
Erik Prabowo,
Dwi Putranti Chitra Sasmitasari,
Dian Oktavianti Putri,
Amrilmaen Badawi
Affiliations
Anis Karuniawati
Department of Microbiology, Faculty of Medicine, Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Merry Ambarwulan
Department of Microbiology, Faculty of Medicine, Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Selvi Nafisa Shahab
Department of Microbiology, Faculty of Medicine, Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Yefta Moenadjat
Department of Surgery, Faculty of Medicine, Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Toar J. M. Lalisang
Department of Surgery, Faculty of Medicine, Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Neneng Dewi Kurniati
Department of Medical Microbiology, Faculty of Medicine, Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia
Kuntaman
Department of Medical Microbiology, Faculty of Medicine, Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia
Vicky Sumarki Budipramana
Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia
Tomy Lesmana
Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya 60286, Indonesia
Iva Puspitasari
Dr. Kariadi General Hospital, Semarang 50244, Indonesia
Erik Prabowo
Dr. Kariadi General Hospital, Semarang 50244, Indonesia
Dwi Putranti Chitra Sasmitasari
Faculty of Medicine, Diponegoro University, Semarang 502775, Indonesia
Dian Oktavianti Putri
Faculty of Medicine, Diponegoro University, Semarang 502775, Indonesia
Amrilmaen Badawi
Global Medical Scientific Affair, Merck Sharp & Dohme (MSD), Jakarta 10220, Indonesia
Complicated intra-abdominal infections (cIAIs) lead to high morbidity and mortality, especially if poorly managed. However, Indonesia’s microbial pattern and susceptibility data are limited, especially for new antibiotics. Ceftolozane/tazobactam (C/T) is reported to be a new potent antibiotic against various pathogens. Thus, we aim to investigate C/T in vitro activity against clinical isolates from cIAI patients. This prospective cross-sectional study was conducted in three major referral hospitals in Indonesia, including Dr. Cipto Mangunkusumo Hospital (Jakarta), Dr. Kariadi Hospital (Semarang), and Dr. Soetomo Hospital (Surabaya), enrolling those diagnosed with cIAIs. Blood specimens were collected before or after at least 72 h of the last antibiotic administration. Meanwhile, tissue biopsy/aspirate specimens were collected intraoperatively. These specimens were cultured, followed by a susceptibility test for specific pathogens. The minimum inhibitory concentration (MIC) of isolates was determined according to CLSI M100. Two-hundred-and-eighty-four patients were enrolled from 2019–2021. Blood culture was dominated by Gram-positive bacteria (GPB, n = 25, 52.1%), whereas abdominal tissue culture was dominated by Gram-negative bacteria (GNB, n = 268, 79.5%). The three most common organisms were GNB, including E. coli, K. pneumoniae, and P. aeruginosa. C/T was susceptible in 96.7%, 70.2%, and 94.1% of the E. coli, K. pneumoniae, and P. aeruginosa isolates, respectively. In addition, C/T also remained active against ESBL Enterobacterales and carbapenem-non-susceptible P. aeruginosa. Overall, C/T demonstrates a high potency against GNB isolates and can be considered an agent for carbapenem-sparing strategy for cIAI patients as the susceptibility is proven.
