Portal de Periódicos da CAPES

Activity of imipenem/relebactam against a Spanish nationwide collection of carbapenemase-producing Enterobacterales

2021; Oxford University Press; Volume: 76; Issue: 6 Linguagem: Inglês

10.1093/jac/dkab043

1460-2091

Juan Carlos Vázquez-Ucha, Alejandro Seoane-Estévez, Bruno K. Rodiño‐Janeiro, Mónica González-Bardanca, Kelly Conde‐Pérez, Marta Martínez-Guitián, Laura Álvarez-Fraga, Jorge Arca-Suárez, Cristina Lasarte-Monterrubio, Marta Gut, Marta Gut, Miguel Álvarez-Tejado, Marina Oviaño, Alejandro Beceiro, Germán Bou, Irene Merino, Emilia Cercenado, Rosa Gómez, Tamara Soler, Irene Gracia-Ahufinger, L. Hibberd Martin, Fátima Galán‐Sánchez, Nuria Tormo, Juan Carlos Rodrı́guez, Sílvia Capilla, Francesc Marco, María Dolores Quesada, Emma Padilla, Fé Tubau, Juanjo González, Ana Isabel López‐Calleja, José Luís del Pozo, María Inmaculada García, Mariela Martínez, Jorge Calvo, Xavier Mulet, F. J. García Peña, Ana Isabel Rodríguez, María José Gude, Ana Fernández‐Palacín, Javier Fernández,

Pneumonia and Respiratory Infections

Imipenem/relebactam is a novel carbapenem/β-lactamase inhibitor combination, developed to act against carbapenemase-producing Enterobacterales (CPE).To assess the in vitro activity of imipenem/relebactam against a Spanish nationwide collection of CPE by testing the susceptibility of these isolates to 16 widely used antimicrobials and to determine the underlying β-lactam resistance mechanisms involved and the molecular epidemiology of carbapenemases in Spain.Clinical CPE isolates (n = 401) collected for 2 months from 24 hospitals in Spain were tested. MIC50, MIC90 and susceptibility/resistance rates were interpreted in accordance with the EUCAST guidelines. β-Lactam resistance mechanisms and molecular epidemiology were characterized by WGS.For all isolates, high rates of susceptibility to colistin (86.5%; MIC50/90 = 0.12/8 mg/L), imipenem/relebactam (85.8%; MIC50/90 = 0.5/4 mg/L) and ceftazidime/avibactam (83.8%, MIC50/90 = 1/≥256 mg/L) were observed. The subgroups of isolates producing OXA-48-like (n = 305, 75.1%) and KPC-like enzymes (n = 44, 10.8%) were highly susceptible to ceftazidime/avibactam (97.7%, MIC50/90 = 1/2 mg/L) and imipenem/relebactam (100.0%, MIC50/90 = ≤0.25/1 mg/L), respectively.The most widely disseminated high-risk clones of carbapenemase-producing Klebsiella pneumoniae across Spain were found to be ST11, ST147, ST392 and ST15 (mostly associated with OXA-48) and ST258/512 (in all cases producing KPC).Imipenem/relebactam, colistin and ceftazidime/avibactam were the most active antimicrobials against all CPEs. Imipenem/relebactam is a valuable addition to the antimicrobial arsenal used in the fight against CPE, particularly against KPC-producing isolates, which in all cases were susceptible to this combination.