1. Increased zinc levels facilitate phenotypic detection of ceftazidime-avibactam resistance in metallo-β-lactamase-producing Gram-negative bacteria.
- Author
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Simon, Michaela, Gerlach, Roman G., Pfeifer, Yvonne, Pfennigwerth, Niels, Gatermann, Sören G., Schröder, Agnes, Hiergeist, Andreas, Hamprecht, Axel, Rügamer, Tamara, Gessner, André, and Jantsch, Jonathan
- Subjects
CEFTAZIDIME ,GRAM-negative bacteria ,MICROBIAL sensitivity tests ,ENTEROBACTERIACEAE ,ZINC ,PHENOTYPES ,ZINC supplements ,PSEUDOMONAS aeruginosa - Abstract
Ceftazidime-avibactam is one of the last resort antimicrobial agents for the treatment of carbapenem-resistant, Gram-negative bacteria. Metallo-β-lactamase-producing bacteria are considered to be ceftazidime-avibactam resistant. Here, we evaluated a semi-automated antimicrobial susceptibility testing system regarding its capability to detect phenotypic ceftazidimeavibactam resistance in 176 carbapenem-resistant, metallo-β-lactamaseproducing Enterobacterales and Pseudomonas aeruginosa isolates. Nine clinical isolates displayed ceftazidime-avibactam susceptibility in the semiautomated system and six of these isolates were susceptible by broth microdilution, too. In all nine isolates, metallo-β-lactamase-mediated hydrolytic activity was demonstrated with the EDTA-modified carbapenemase inactivation method. As zinc is known to be an important co-factor for metallo-β-lactamase activity, test media of the semi-automated antimicrobial susceptibility testing system and broth microdilution were supplemented with zinc. Thereby, the detection of phenotypic resistance was improved in the semi-automated system and in broth microdilution. Currently, ceftazidimeavibactam is not approved as treatment option for infections by metallo-β-lactamase-producing, Gram-negative bacteria. In infections caused by carbapenem-resistant Gram-negatives, we therefore recommend to rule out the presence of metallo-β-lactamases with additional methods before initiating ceftazidime-avibactam treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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