Susceptibility of Multidrug-Resistant , , and from Germany to Ceftolozane-Tazobactam, Ceftazidime-Avibactam, and Imipenem-Relebactam.

This cross-sectional in-vitro resistance surveillance study involving 10 medical laboratories was conducted in 2018. Each study site was asked to collect 30 consecutive nonduplicate isolates per species from hospitalized patients with documented infections. Minimum inhibitory concentrations were determined at a central laboratory. European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints were used for interpretation. A total of 860 isolates were collected, including 298 , 268 , and 294 . Fifty (16.8%) and 63 (23.5%) isolates were found to be resistant to third-generation cephalosporins. Resistance to carbapenems (imipenem and/or meropenem) was identified in 5 (1.9%) and 64 (21.8%) , but not in . Thirty-three (11.2%) isolates were resistant to both carbapenems and 30 (10.2%) showed resistance to ≥3 antimicrobials/antimicrobial groups (among piperacillin-tazobactam, ceftazidime, tobramycin, carbapenems, and fluoroquinolones). The susceptibility rates of these multidrug-resistant (MDR) phenotypes to ceftolozane-tazobactam, ceftazidime-avibactam, and imipenem-relebactam were 70-100%, with the exception of carbapenem-resistant . Only two and four isolates were resistant to all three beta-lactam/beta-lactamase-inhibitor combinations. However, this favorable result should be viewed in light of the relatively low prevalence of MDR organisms that require these agents in Germany.