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2217. Frequency and Antimicrobial Susceptibility of Bacteria Isolated from Patients Hospitalized with Pneumonia in US Medical Centers During 2018

BACKGROUND: Rapidly introducing appropriate antimicrobial therapy is crucial to reduce morbidity and mortality of patients hospitalized with pneumonia (PHP), and therapy is determined mostly by understanding causative pathogens. Ceftazidime–avibactam (CAZ-AVI) was recently approved and ceftolozane–t...

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Autores principales: Sader, Helio S, Huband, Michael D, Carvalhaes, Cecilia G, Castanheira, Mariana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809730/
http://dx.doi.org/10.1093/ofid/ofz360.1895
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author Sader, Helio S
Huband, Michael D
Carvalhaes, Cecilia G
Castanheira, Mariana
author_facet Sader, Helio S
Huband, Michael D
Carvalhaes, Cecilia G
Castanheira, Mariana
author_sort Sader, Helio S
collection PubMed
description BACKGROUND: Rapidly introducing appropriate antimicrobial therapy is crucial to reduce morbidity and mortality of patients hospitalized with pneumonia (PHP), and therapy is determined mostly by understanding causative pathogens. Ceftazidime–avibactam (CAZ-AVI) was recently approved and ceftolozane–tazobactam (C-T) is in late-stage clinical development for treating nosocomial pneumonia, including ventilator-associated. METHODS: Bacterial isolates were consecutively collected from PHP (1/patient) in 67 US medical centers in 2018 and the Gram-negative bacilli (GNB) were tested by reference broth microdilution methods for susceptibility (S) to CAZ-AVI, C-T, and many comparators at a central laboratory. RESULTS: The most common organisms isolated from PHP were S. aureus (27.0%), P. aeruginosa (PSA) (24.6%), K. pneumoniae (KPN; 7.6%), E. coli (6.8%), S. marcescens (5.4%), and S. maltophilia (XM; 4.5%). Colistin (99.7%S), CAZ-AVI (95.7%S), and C-T (94.9%S) were the most active compounds against PSA; CAZ-AVI (99.9%S), amikacin (AMK; 98.8%S), and meropenem (MEM; 97.6%S) were the most active compounds against Enterobacterales (ENT). CAZ-AVI and C-T retained activity against PSA isolates non-S (NS) to piperacillin–tazobactam (PIP-TAZ), MEM, and cefepime (FEP), whereas PSA isolates NS to PIP-TAZ, MEM, or FEP exhibited low S rates to PIP-TAZ (≤ 39.2%), MEM (≤ 37.8%), and FEP (≤ 38.0%; Table). CAZ-AVI and tigecycline were the only compounds with good activity against carbapenem-resistant ENT (CRE), both with 96.6%S. Among ENT, the most common ESBL and carbapenemase were CTX-M-15 (73%) and KPC-2/3 (76%), respectively. CAZ-AVI was active against all ESBL producers (100.0%S), whereas the S rate to C-T was 82.4%. The most active compounds against multidrug-resistant (MDR) ENT were CAZ-AVI (98.9%S), AMK (91.5%S), and MEM (80.8%S). XM and A. baumannii exhibited low S rates to most antimicrobials tested. CONCLUSION: Gram-negative bacteria were isolated from 70% of PHP, and PSA and ENT represented >80% of these organisms. CAZ-AVI and C-T showed similar coverage (%S) against PSA (95.7–94.9%S). In contrast, C-T was less active than CAZ-AVI against ENT in general and exhibited limited activity against ENT-resistant subsets. [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68097302019-10-28 2217. Frequency and Antimicrobial Susceptibility of Bacteria Isolated from Patients Hospitalized with Pneumonia in US Medical Centers During 2018 Sader, Helio S Huband, Michael D Carvalhaes, Cecilia G Castanheira, Mariana Open Forum Infect Dis Abstracts BACKGROUND: Rapidly introducing appropriate antimicrobial therapy is crucial to reduce morbidity and mortality of patients hospitalized with pneumonia (PHP), and therapy is determined mostly by understanding causative pathogens. Ceftazidime–avibactam (CAZ-AVI) was recently approved and ceftolozane–tazobactam (C-T) is in late-stage clinical development for treating nosocomial pneumonia, including ventilator-associated. METHODS: Bacterial isolates were consecutively collected from PHP (1/patient) in 67 US medical centers in 2018 and the Gram-negative bacilli (GNB) were tested by reference broth microdilution methods for susceptibility (S) to CAZ-AVI, C-T, and many comparators at a central laboratory. RESULTS: The most common organisms isolated from PHP were S. aureus (27.0%), P. aeruginosa (PSA) (24.6%), K. pneumoniae (KPN; 7.6%), E. coli (6.8%), S. marcescens (5.4%), and S. maltophilia (XM; 4.5%). Colistin (99.7%S), CAZ-AVI (95.7%S), and C-T (94.9%S) were the most active compounds against PSA; CAZ-AVI (99.9%S), amikacin (AMK; 98.8%S), and meropenem (MEM; 97.6%S) were the most active compounds against Enterobacterales (ENT). CAZ-AVI and C-T retained activity against PSA isolates non-S (NS) to piperacillin–tazobactam (PIP-TAZ), MEM, and cefepime (FEP), whereas PSA isolates NS to PIP-TAZ, MEM, or FEP exhibited low S rates to PIP-TAZ (≤ 39.2%), MEM (≤ 37.8%), and FEP (≤ 38.0%; Table). CAZ-AVI and tigecycline were the only compounds with good activity against carbapenem-resistant ENT (CRE), both with 96.6%S. Among ENT, the most common ESBL and carbapenemase were CTX-M-15 (73%) and KPC-2/3 (76%), respectively. CAZ-AVI was active against all ESBL producers (100.0%S), whereas the S rate to C-T was 82.4%. The most active compounds against multidrug-resistant (MDR) ENT were CAZ-AVI (98.9%S), AMK (91.5%S), and MEM (80.8%S). XM and A. baumannii exhibited low S rates to most antimicrobials tested. CONCLUSION: Gram-negative bacteria were isolated from 70% of PHP, and PSA and ENT represented >80% of these organisms. CAZ-AVI and C-T showed similar coverage (%S) against PSA (95.7–94.9%S). In contrast, C-T was less active than CAZ-AVI against ENT in general and exhibited limited activity against ENT-resistant subsets. [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809730/ http://dx.doi.org/10.1093/ofid/ofz360.1895 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Sader, Helio S
Huband, Michael D
Carvalhaes, Cecilia G
Castanheira, Mariana
2217. Frequency and Antimicrobial Susceptibility of Bacteria Isolated from Patients Hospitalized with Pneumonia in US Medical Centers During 2018
title 2217. Frequency and Antimicrobial Susceptibility of Bacteria Isolated from Patients Hospitalized with Pneumonia in US Medical Centers During 2018
title_full 2217. Frequency and Antimicrobial Susceptibility of Bacteria Isolated from Patients Hospitalized with Pneumonia in US Medical Centers During 2018
title_fullStr 2217. Frequency and Antimicrobial Susceptibility of Bacteria Isolated from Patients Hospitalized with Pneumonia in US Medical Centers During 2018
title_full_unstemmed 2217. Frequency and Antimicrobial Susceptibility of Bacteria Isolated from Patients Hospitalized with Pneumonia in US Medical Centers During 2018
title_short 2217. Frequency and Antimicrobial Susceptibility of Bacteria Isolated from Patients Hospitalized with Pneumonia in US Medical Centers During 2018
title_sort 2217. frequency and antimicrobial susceptibility of bacteria isolated from patients hospitalized with pneumonia in us medical centers during 2018
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809730/
http://dx.doi.org/10.1093/ofid/ofz360.1895
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