In Vitro Efficacy of Ceftazidime-Avibactam among Carbapenem Resistant Enterobacterales and Pseudomonas aeruginosa Clinical Isolates in Specialized Pediatric Hospital
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Keywords
Ceftazidime-avibactam, Carbapenem resistant, Multiplex PCR
Abstract
Background: Carbapenem-resistant organisms (CRO) have been disseminated worldwide. Ceftazidime-avibactam (CZA/AVI) has been suggested as an alternative option.
Objectives: This study aims to assess the prevalence of CRO among clinical isolates and to investigate the in vitro antimicrobial activity of CZA/AVI.
Design: Our observational experimental in vitro study was conducted over one year.
Settings: Pediatric specialized teaching hospital.
Material and Methods: Identification was done by MALDI-TOF-MS. CZA/AVI susceptibility testing was done by disk diffusion. The presence of carbapenemases was detected by modified carbapenem inactivation method and multiplex PCR tests.
Main Outcome Measures: Prevalence of CRO was 72.6%; (80.0%) of our isolates were Klebsiella pneumoniae. The most frequently detected carbapenamase genes were blaNDM (70.0%), followed by blaOXA-48 (68.24%) and blaKPC (16.47%).
Sample size: 170 clinical isolates of Enterobacterales and Pseudomonas aeruginosa.
Result: CZA/AVI in vitro efficacy was 30.0%.
Conclusion: Due to the high prevalence of metallo B lactamases in our hospital CZA/AVI may not be a good therapeutic option for CRO infections, emphasizing the importance of improving infection prevention and control.
Limitations: larger sample size is needed and studying the in vivo response in correlation with the invitro results will be of great benefit.
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