Infect Drug Resist
Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Published: October 2022
Background: A growing body of evidence suggests that ceftazidime/avibactam (CZA) is a potential therapeutic option for carbapenem-resistant (CRKP) infections; however, resistant strains are increasingly emerged worldwide. Herein, we deemed to investigate the susceptibility profile of CRKP isolates from cancer patients to CZA and to identify the underlying resistance mechanisms.
Methods: Clinical samples were obtained from adult patients admitted to the Oncology Center of Mansoura University, Mansoura, Egypt. The antibiotic susceptibility pattern of e isolates to different antibiotics was tested by the modified Kirby Bauer's disc diffusion method. Minimum inhibitory concentrations of CZA were assessed using broth microdilution method. Screening for carbapenemase-producing strains was achieved by the modified Hodge test. Multiplex polymerase chain reactions (PCRs) were conducted for uncovering of carbapenemase-encoding genes ( , and ), and outer membrane porin genes (and).
Results: A total of 12 CZA-resistant isolates were identified out of 47 CRKP isolates (25.5%). The MIC and MIC of CZA against CRKP were 1 and 64 µg/mL, respectively. Risk factors for CZA resistance included chronic kidney disease, mechanical ventilation, longer length of hospital stay, and ICU admission. The multivariate logistic regression demonstrated that longer length of hospital stay (=0.03) was the only independent predictor for acquisition of CZA-resistant isolates. The leading mechanism for CZA resistance was sustained by (50%), meanwhile 16.7% and 8.3% of the CZA-resistant isolates harbored and / , respectively. The MBL-encoding genes and were detected in 16.7% and 8.3% of the isolates, respectively. Absence of both and was observed in 58.3% of the CZA-resistant isolates.
Conclusion: CZA has displayed superior in vitro activity against CRKP isolates in comparison to other antibiotics; however, thorough molecular characterization of resistant strains is highly recommended in future studies to detect and monitor the emergence of further tackling strains.
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Source |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9558567 | PMC |
http://dx.doi.org/10.2147/IDR.S384972 | DOI Listing |
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