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Activity of ceftazidime-avibactam against carbapenemase-producing Enterobacteriaceae from urine specimens obtained during the infection-carbapenem resistance evaluation surveillance trial (iCREST) in Spain

2018; Elsevier BV; Volume: 51; Issue: 3 Linguagem: Inglês

10.1016/j.ijantimicag.2018.01.011

1872-7913

María García-Castillo, Sergio García‐Fernández, Rosa Gómez-Gil, Cristina Pitart, Marina Oviaño, Irene Gracia-Ahufinger, Jazmín Díaz-Regañón, Marta Tato, Rafael Cantón, Germán Bou, Marina Oviaño, Julio García‐Rodríguez, Rosa Gómez Gil, Luis Martínez‐Martínez, Irene Gracia Ahufinger, Jordi Vilà, Francesc Marco, Cristina Pitart, María García del Castillo, Sergio García‐Fernández, Marta Tato, Rafael Cantón,

Urinary Tract Infections Management

The increasing rates of carbapenemase-producing Enterobacteriaceae (CPE) represent an important threat to health care systems and treatment of CPE infections is a challenge. The aim of the infection-carbapenem resistance evaluation surveillance trial (iCREST) was to determinate the prevalence of CPE in urine specimens in Spain and to evaluate the in vitro activity of ceftazidime-avibactam. Urine specimens (n = 11 826) were included and activity of ceftazidime-avibactam and comparators were investigated by broth microdilution in CPE. Carbapenemases were characterised by polymerase chain reaction (PCR) and sequencing as well as by whole genome sequencing (WGS). Overall prevalence of CPE was 1.6%. OXA-48 was the most prevalent (86.8%), followed by KPC (6.9%), VIM (4.8%), NDM (1.1%) and IMP (0.6%) carbapenemases. Klebsiella pneumoniae was the most common carbapenemase producer (87.8%). An uncommon carbapenemase type (IMP-8) in Spain was identify by WGS in an Enterobacter cloacae isolate, reinforcing the utility of surveillance programmes as effectives tools to detect unexpected genes that encode antimicrobial resistance. Ceftazidime-avibactam showed 100% susceptibility in KPC and OXA-48 producers and the rates of susceptibility in CPE non-susceptible to ceftazidime or meropenem were 92.1% and 96.9%, respectively. Ceftazidime-avibactam could be considered an adequate treatment option for urinary tract infections caused by KPC and OXA-48 producers.