In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent β-lactam/β-lactamase inhibitor combinations

Carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter spp. represent major threats and have few approved therapeutic options. Non-‍fermenting Gram-negative isolates were collected from hospitalized inpatients from 49 sites in 6 European countries between 01 January 2020 and 31 December 2020...

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Authors: Santerre Henriksen, Anne, Jeannot, Katy, Oliver, Antonio, Perry, John D., Pletz, Mathias W., Stefani, Stefania, Morrissey, Ian, Longshaw, Christopher, ARTEMIS Study Investigators, López Cerero, Lorena
Format: article
Status:Published version
Publication Date:2024
Country:España
Institution:Universidad de Sevilla (US)
Repository:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/171365
Online Access:https://hdl.handle.net/11441/171365
https://doi.org/10.1128/spectrum.03836-23
Access Level:Open access
Keyword:Cefiderocol
Pseudomonas aeruginosa
Acinetobacter spp.
β-lactam/β-lactamase inhibitor combinations
Meropenem
Ceftazidime-avibactam
Ceftolozane-tazobactam
Meropenem-vaborbactam
Imipenem-relebactam
Aztreonam-avibactam
Cefepime-taniborbactam
Sulbactam-durlobactam
Resistance
Meropenem-resistant
β-lactamases
Europe
In vitro
id ES_a0b603e7b57fe1d6004e1b16add7a385
oai_identifier_str oai:idus.us.es:11441/171365
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent β-lactam/β-lactamase inhibitor combinations
title In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent β-lactam/β-lactamase inhibitor combinations
spellingShingle In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent β-lactam/β-lactamase inhibitor combinations
Santerre Henriksen, Anne
Cefiderocol
Pseudomonas aeruginosa
Acinetobacter spp.
β-lactam/β-lactamase inhibitor combinations
Meropenem
Ceftazidime-avibactam
Ceftolozane-tazobactam
Meropenem-vaborbactam
Imipenem-relebactam
Aztreonam-avibactam
Cefepime-taniborbactam
Sulbactam-durlobactam
Resistance
Meropenem-resistant
β-lactamases
Europe
In vitro
title_short In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent β-lactam/β-lactamase inhibitor combinations
title_full In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent β-lactam/β-lactamase inhibitor combinations
title_fullStr In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent β-lactam/β-lactamase inhibitor combinations
title_full_unstemmed In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent β-lactam/β-lactamase inhibitor combinations
title_sort In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent β-lactam/β-lactamase inhibitor combinations
dc.creator.none.fl_str_mv Santerre Henriksen, Anne
Jeannot, Katy
Oliver, Antonio
Perry, John D.
Pletz, Mathias W.
Stefani, Stefania
Morrissey, Ian
Longshaw, Christopher
ARTEMIS Study Investigators
López Cerero, Lorena
author Santerre Henriksen, Anne
author_facet Santerre Henriksen, Anne
Jeannot, Katy
Oliver, Antonio
Perry, John D.
Pletz, Mathias W.
Stefani, Stefania
Morrissey, Ian
Longshaw, Christopher
ARTEMIS Study Investigators
López Cerero, Lorena
author_role author
author2 Jeannot, Katy
Oliver, Antonio
Perry, John D.
Pletz, Mathias W.
Stefani, Stefania
Morrissey, Ian
Longshaw, Christopher
ARTEMIS Study Investigators
López Cerero, Lorena
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Microbiología
CTS210: Resistencia a Antimicrobianos
dc.subject.none.fl_str_mv Cefiderocol
Pseudomonas aeruginosa
Acinetobacter spp.
β-lactam/β-lactamase inhibitor combinations
Meropenem
Ceftazidime-avibactam
Ceftolozane-tazobactam
Meropenem-vaborbactam
Imipenem-relebactam
Aztreonam-avibactam
Cefepime-taniborbactam
Sulbactam-durlobactam
Resistance
Meropenem-resistant
β-lactamases
Europe
In vitro
topic Cefiderocol
Pseudomonas aeruginosa
Acinetobacter spp.
β-lactam/β-lactamase inhibitor combinations
Meropenem
Ceftazidime-avibactam
Ceftolozane-tazobactam
Meropenem-vaborbactam
Imipenem-relebactam
Aztreonam-avibactam
Cefepime-taniborbactam
Sulbactam-durlobactam
Resistance
Meropenem-resistant
β-lactamases
Europe
In vitro
description Carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter spp. represent major threats and have few approved therapeutic options. Non-‍fermenting Gram-negative isolates were collected from hospitalized inpatients from 49 sites in 6 European countries between 01 January 2020 and 31 December 2020 and underwent susceptibility testing against cefiderocol and β-lactam/β-lactamase inhibitor combinations. Meropenem-resistant (MIC >8 mg/L), cefiderocol-susceptible isolates were analyzed by PCR, and cefiderocol-resistant isolates were analyzed by whole-genome sequencing to identify resistance mechanisms. Overall, 1,451 (950 P. aeruginosa; 501 Acinetobacter spp.) isolates were collected, commonly from the respiratory tract (42.0% and 39.3%, respectively). Cefiderocol susceptibility was higher than ‍β‍-‍l‍a‍c‍t‍a‍m‍/‍β‍-‍l‍a‍c‍t‍a‍mase‍ inhibitor combinations against P. aeruginosa (98.9% vs 83.3%–91.4%), and P. ‍aeruginosa resistant to meropenem (n = 139; 97.8% vs 12.2%–59.7%), β-lactam/β-lactamase inhibitor combinations (93.6%–98.1% vs 10.7%–71.8%), and both meropenem and ceftazidime-avibactam (96.7% vs 5.0%–‍‍45.0%) or ‍ceftolozane-tazobactam (98.4% vs 8.1%–54.8%), respectively. Cefiderocol and sulbactam-durlobactam susceptibilities were high against Acinetobacter spp. (92.4% and 97.0%) and meropenem-resistant Acineto‍bacter ‍spp. (n = 227; 85.0% and 93.8%) but lower against sulbactam-durlobactam- (n ‍= 15; 13.3%) and cefiderocol- (n = 38; 65.8%) resistant isolates, respectively. Among meropenem-resistant P. aeruginosa and Acinetobacter spp., the most common β-‍‍lactamase genes were metallo-β-lactamases [30/139; blaVIM-2 (15/139)] and oxacillinases [215/227; blaOXA-23 (194/227)], respectively. Acquired β-lactamase genes were identified in 1/10 and 32/38 of cefiderocol-resistant P. aeruginosa and Acinetobacter spp., and pirA-like or piuA mutations in 10/10 and 37/38, respectively. Conclusion: cefiderocol susceptibility was high against P. aeruginosa and Acinetobacter spp., including meropenem-resistant isolates and those resistant to recent β-lactam/β-lactamase inhibitor combinations common in first-line treatment of European non-fermenters. IMPORTANCEThis was the first study in which the in vitro activity of cefiderocol and non-licensed β-lactam/β-lactamase inhibitor combinations were directly compared against Pseudomonas aeruginosa and Acinetobacter spp., including meropenem- and β-lactam/β-lactamase inhibitor combination-resistant isolates. A notably large number of European isolates were collected. Meropenem resistance was defined according to the MIC breakpoint for high-dose meropenem, ensuring that data reflect antibiotic activity against isolates that would remain meropenem resistant in the clinic. Cefiderocol susceptibility was high against non-fermenters, and there was no apparent cross resistance between cefiderocol and β-lactam/β-lactamase inhibitor combinations, with the exception of sulbactam-durlobactam. These results provide insights into therapeutic options for infections due to resistant P. aeruginosa and Acinetobacter spp. and indicate how early susceptibility testing of cefiderocol in parallel with β-lactam/β-lactamase inhibitor combinations will allow clinicians to choose the effective treatment(s) from all available options. This is particularly important as current treatment options against non-fermenters are limited.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/171365
https://doi.org/10.1128/spectrum.03836-23
url https://hdl.handle.net/11441/171365
https://doi.org/10.1128/spectrum.03836-23
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Microbiology Spectrum, 12 (4), e03836-23.
https://journals.asm.org/doi/epub/10.1128/spectrum.03836-23
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv American Society for Microbiology
publisher.none.fl_str_mv American Society for Microbiology
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869415051027283968
spelling In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent β-lactam/β-lactamase inhibitor combinationsSanterre Henriksen, AnneJeannot, KatyOliver, AntonioPerry, John D.Pletz, Mathias W.Stefani, StefaniaMorrissey, IanLongshaw, ChristopherARTEMIS Study InvestigatorsLópez Cerero, LorenaCefiderocolPseudomonas aeruginosaAcinetobacter spp.β-lactam/β-lactamase inhibitor combinationsMeropenemCeftazidime-avibactamCeftolozane-tazobactamMeropenem-vaborbactamImipenem-relebactamAztreonam-avibactamCefepime-taniborbactamSulbactam-durlobactamResistanceMeropenem-resistantβ-lactamasesEuropeIn vitroCarbapenem-resistant Pseudomonas aeruginosa and Acinetobacter spp. represent major threats and have few approved therapeutic options. Non-‍fermenting Gram-negative isolates were collected from hospitalized inpatients from 49 sites in 6 European countries between 01 January 2020 and 31 December 2020 and underwent susceptibility testing against cefiderocol and β-lactam/β-lactamase inhibitor combinations. Meropenem-resistant (MIC >8 mg/L), cefiderocol-susceptible isolates were analyzed by PCR, and cefiderocol-resistant isolates were analyzed by whole-genome sequencing to identify resistance mechanisms. Overall, 1,451 (950 P. aeruginosa; 501 Acinetobacter spp.) isolates were collected, commonly from the respiratory tract (42.0% and 39.3%, respectively). Cefiderocol susceptibility was higher than ‍β‍-‍l‍a‍c‍t‍a‍m‍/‍β‍-‍l‍a‍c‍t‍a‍mase‍ inhibitor combinations against P. aeruginosa (98.9% vs 83.3%–91.4%), and P. ‍aeruginosa resistant to meropenem (n = 139; 97.8% vs 12.2%–59.7%), β-lactam/β-lactamase inhibitor combinations (93.6%–98.1% vs 10.7%–71.8%), and both meropenem and ceftazidime-avibactam (96.7% vs 5.0%–‍‍45.0%) or ‍ceftolozane-tazobactam (98.4% vs 8.1%–54.8%), respectively. Cefiderocol and sulbactam-durlobactam susceptibilities were high against Acinetobacter spp. (92.4% and 97.0%) and meropenem-resistant Acineto‍bacter ‍spp. (n = 227; 85.0% and 93.8%) but lower against sulbactam-durlobactam- (n ‍= 15; 13.3%) and cefiderocol- (n = 38; 65.8%) resistant isolates, respectively. Among meropenem-resistant P. aeruginosa and Acinetobacter spp., the most common β-‍‍lactamase genes were metallo-β-lactamases [30/139; blaVIM-2 (15/139)] and oxacillinases [215/227; blaOXA-23 (194/227)], respectively. Acquired β-lactamase genes were identified in 1/10 and 32/38 of cefiderocol-resistant P. aeruginosa and Acinetobacter spp., and pirA-like or piuA mutations in 10/10 and 37/38, respectively. Conclusion: cefiderocol susceptibility was high against P. aeruginosa and Acinetobacter spp., including meropenem-resistant isolates and those resistant to recent β-lactam/β-lactamase inhibitor combinations common in first-line treatment of European non-fermenters. IMPORTANCEThis was the first study in which the in vitro activity of cefiderocol and non-licensed β-lactam/β-lactamase inhibitor combinations were directly compared against Pseudomonas aeruginosa and Acinetobacter spp., including meropenem- and β-lactam/β-lactamase inhibitor combination-resistant isolates. A notably large number of European isolates were collected. Meropenem resistance was defined according to the MIC breakpoint for high-dose meropenem, ensuring that data reflect antibiotic activity against isolates that would remain meropenem resistant in the clinic. Cefiderocol susceptibility was high against non-fermenters, and there was no apparent cross resistance between cefiderocol and β-lactam/β-lactamase inhibitor combinations, with the exception of sulbactam-durlobactam. These results provide insights into therapeutic options for infections due to resistant P. aeruginosa and Acinetobacter spp. and indicate how early susceptibility testing of cefiderocol in parallel with β-lactam/β-lactamase inhibitor combinations will allow clinicians to choose the effective treatment(s) from all available options. This is particularly important as current treatment options against non-fermenters are limited.American Society for MicrobiologyMicrobiologíaCTS210: Resistencia a Antimicrobianos2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/171365https://doi.org/10.1128/spectrum.03836-23reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésMicrobiology Spectrum, 12 (4), e03836-23.https://journals.asm.org/doi/epub/10.1128/spectrum.03836-23info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1713652026-06-17T12:51:07Z
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