AI Article Synopsis
- Carbapenem-nonsusceptible and multidrug-resistant (MDR) bacteria, often found in lower respiratory tract infections (LRTIs) and intensive care units (ICUs), present significant treatment challenges, making the need for new therapies urgent.
- A study analyzed the effectiveness of two β-lactam/β-lactamase inhibitor combinations—ceftolozane/tazobactam (C/T) and imipenem/relebactam (IMI/REL)—on bacterial isolates from ICU and non-ICU patients across 26 US hospitals.
- Findings showed that C/T and IMI/REL were highly effective against most MDR isolates, with very few being resistant, suggesting these drugs should
Article Abstract
Background: Carbapenem-nonsusceptible and multidrug-resistant (MDR) , which are more common in patients with lower respiratory tract infections (LRTIs) and in patients in intensive care units (ICUs), pose difficult treatment challenges and may require new therapeutic options. Two β-lactam/β-lactamase inhibitor combinations, ceftolozane/tazobactam (C/T) and imipenem/relebactam (IMI/REL), are approved for treatment of hospital-acquired/ventilator-associated bacterial pneumonia.
Methods: The Clinical and Laboratory Standards Institute-defined broth microdilution methodology was used to determine minimum inhibitory concentrations (MICs) against isolates collected from patients with LRTIs in ICUs (n = 720) and non-ICU wards (n = 914) at 26 US hospitals in 2017-2019 as part of the Study for Monitoring Antimicrobial Resistance Trends (SMART) surveillance program.
Results: Susceptibility to commonly used β-lactams including carbapenems was 5-9 percentage points lower and MDR rates 7 percentage points higher among isolates from patients in ICUs than those in non-ICU wards ( < .05). C/T and IMI/REL maintained activity against 94.0% and 90.8% of ICU isolates, respectively, while susceptibility to all comparators except amikacin (96.0%) was 63%-76%. C/T and IMI/REL inhibited 83.1% and 68.1% of meropenem-nonsusceptible (n = 207) and 71.4% and 65.7% of MDR ICU isolates (n = 140), respectively. Among all ICU isolates, only 2.5% were nonsusceptible to both C/T and IMI/REL, while 6.7% were susceptible to C/T but not to IMI/REL and 3.5% were susceptible to IMI/REL but not to C/T.
Conclusions: These data suggest that susceptibility to both C/T and IMI/REL should be considered for testing at hospitals, as both agents could provide important new options for treating patients with LRTIs, especially in ICUs where collected isolates show substantially reduced susceptibility to commonly used β-lactams.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297703 | PMC |
| http://dx.doi.org/10.1093/ofid/ofab320 | DOI Listing |
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