Real-World Performance of Susceptibility Testing for Ceftolozane/Tazobactam against Non-Carbapenemase- Producing Carbapenem-Resistant Pseudomonas aeruginosa

dc.article.numbere01657-21
dc.catalogadordfo
dc.contributor.authorRivas, Lina
dc.contributor.authorMartinez, José R.W.
dc.contributor.authorMunita, José M.
dc.contributor.authorAlcalde-Rico, Manuel
dc.contributor.authorOlivares Pacheco, Jorge
dc.contributor.authorGarcía Cañete, Patricia
dc.contributor.authorOlivares-Pacheco J.
dc.contributor.authorMoreno, María Victoria
dc.contributor.authorRojas, Pamela
dc.contributor.authorWozniak Banchero, Aniela
dc.contributor.authorMiller, William
dc.contributor.authorArias, Cesar A.
dc.contributor.authorKhan, Ayesha
dc.date.accessioned2024-01-29T16:04:27Z
dc.date.available2024-01-29T16:04:27Z
dc.date.issued2022
dc.description.abstractCeftolozane/tazbactam (C/T) is a potent anti-pseudomonal agent that has clinical utility against infections caused by non-carbapenemase, producing-carbapenemresistant Pseudomonas aeruginosa (non-CP-CR-PA). Accurate, precise, and reliable antimicrobial susceptibility testing (AST) is crucial to guide clinical decisions. However, studies assessing the performance of different AST methods against non-CP-CR-PA (the main clinical niche for C/T), are lacking. Here, we evaluated performance of gradient strips (Etest and MIC test strip [MTS], and disk diffusion [DD]) using CLSI breakpoints. Additionally, we assessed the performance of DD using EUCAST breakpoints. For all susceptibility tests, we used a collection of 97 non-CP-CR-PA clinical isolates recovered from 11 Chilean hospitals. Both gradient strips and DD had acceptable performance when using CLSI breakpoints, yielding a categorical agreement (CA) of .90% and 92%, respectively. In contrast, DD using EUCAST breakpoints performed suboptimally (CA 81%). MTS yielded a higher essential agreement (EA, .90%) than Etest (84%). Importantly, the performance of all methods varied significantly when the isolates were stratified by their degree of susceptibility to other anti-pseudomonal b-lactams. All methods had 100% CA when testing isolates that were pan-susceptible to all b-lactams (Pan-β-S). However, the CA markedly decreased when testing isolates resistant to all b-lactams (Pan-β-R). Indeed, the CA was 81% for Etest (six errors), 78% for MTS (seven errors), and 78% and 56% for DD when using CLSI (seven errors) or EUCAST breakpoints (14 errors), respectively. Our results suggest that all manual AST methods have strikingly decreased performance in the context of Pan-β-R P. aeruginosa with potentially major clinical implications.
dc.fuente.origenScopus
dc.identifier.doi10.1128/AAC.01657-21
dc.identifier.pubmedid34780269
dc.identifier.scopusidSCOPUS_ID:85123087521
dc.identifier.urihttps://journals.asm.org/doi/10.1128/AAC.01657-21
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/81004
dc.information.autorucEscuela de Medicina; Wozniak Banchero Aniela; 0000-0001-9559-7660; 1008612
dc.information.autorucEscuela de Medicina; Garcia Canete Patricia Del Carmen; 0000-0002-3817-4896; 73909
dc.issue.numero1
dc.language.isoen
dc.revistaAntimicrobial Agents and Chemotherapy
dc.rightscontenido parcial
dc.rightsacceso restringido
dc.subjectAntibiotic resistance
dc.subjectAntimicrobial activity
dc.subjectBeta-lactams
dc.subjectBloodstream infections
dc.subjectCarbapenem-resistant P. aeruginosa
dc.subjectCeftolozane/tazobactam
dc.subjectGram-negative bacteria
dc.subjectInfectious disease
dc.subjectMultidrug resistance
dc.subjectNon-carbapenemase-producing
dc.subjectPseudomonas
dc.subjectPseudomonas aeruginosa
dc.subjectSusceptibility testing
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleReal-World Performance of Susceptibility Testing for Ceftolozane/Tazobactam against Non-Carbapenemase- Producing Carbapenem-Resistant Pseudomonas aeruginosa
dc.typeartículo
dc.volumen66
sipa.codpersvinculados1008612
sipa.codpersvinculados73909
sipa.trazabilidadSCOPUS;21-03-2022
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