Antibiotic Susceptibility of Aerobic and Facultative Anaerobic Gram-Negative Rods in Hong Kong and Implications on Usefulness of Ceftazidime-Avibactam and Ceftolozane-Tazobactam
Abstract
:1. Introduction
2. Results
2.1. Collection of Bacterial Strains
2.2. Antimicrobial Susceptibilities of Non-Multidrug Resistant (MDR) Isolates
2.3. Antimicrobial Susceptibilities of MDR Isolates
3. Discussion
4. Materials and Methods
4.1. Bacterial Strains
4.2. Detection of ESBL Production
4.3. Detection of Carbapenemase Production
4.4. Determination of Antimicrobial Susceptibility by Broth Microdilution Method
4.5. Determination of Antimicrobial Susceptibility Using MIC Test Strip Method
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Antimicrobial Agent a,b | MIC (mg/L) | Susceptibility d (%) | |||||
---|---|---|---|---|---|---|---|
Range | MIC50 c | MIC90 c | S | SDD | I | R | |
Non-MDR E. coli (n = 92) | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | 0.094 | 0.19 | 100 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | 0.19 | 0.38 | 98.9 | - | 0.0 | 1.1 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | 2 | 32 | 88.0 | 1.1 | - | 10.9 |
Ceftazidime | ≤0.125 to ≥256 | 0.25 | 1 | 94.6 | - | 1.1 | 4.3 |
Meropenem | ≤0.125 to ≥256 | ≤0.125 | 0.25 | 98.9 | - | 0.0 | 1.1 |
Cefepime | ≤0.125 to ≥256 | ≤0.125 | 2 | 92.4 | 4.3 | - | 3.3 |
Colistin | ≤0.125 to ≥256 | 0.125 | 0.5 | - | - | 97.8 | 2.2 |
ESBL-producing E. coli (n = 44) | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | 0.125 | 0.25 | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | 0.25 | 0.5 | 97.7 | - | 0.0 | 2.3 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | 4 | 64 | 61.4 | 6.8 | - | 31.8 |
Ceftazidime | ≤0.125 to ≥256 | 8 | 128 | 36.4 | - | 13.6 | 50.0 |
Meropenem | ≤0.125 to ≥256 | ≤0.125 | 0.5 | 100.0 | - | 0.0 | 0.0 |
Cefepime | ≤0.125 to ≥256 | 16 | 128 | 15.9 | 22.7 | - | 61.4 |
Colistin | ≤0.125 to ≥256 | 0.125 | 0.5 | - | - | 97.7 | 2.3 |
Carbapenamase-producing E. coli (n = 1) g | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | - | - | 0.0 | - | - | 100 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | - | - | 0.0 | - | 0.0 | 100 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | - | - | 0.0 | 0.0 | - | 100 |
Ceftazidime | ≤0.125 to ≥256 | - | - | 0.0 | - | 0.0 | 100 |
Meropenem | ≤0.125 to ≥256 | - | - | 0.0 | - | 0.0 | 100 |
Cefepime | ≤0.125 to ≥256 | - | - | 0.0 | 0.0 | - | 100 |
Colistin | ≤0.125 to ≥256 | - | - | - | - | 0.0 | 100 |
Non-MDR K. pneumoniae (n = 46) | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | 0.125 | 0.25 | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | 0.25 | 0.5 | 97.8 | - | 2.2 | 0.0 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | 0.5 | 64 | 87.0 | 0.0 | - | 13.0 |
Ceftazidime | ≤0.125 to ≥256 | 1 | 16 | 84.8 | - | 0.0 | 15.2 |
Meropenem | ≤0.125 to ≥256 | 0.125 | 0.25 | 100.0 | - | 0.0 | 0.0 |
Cefepime | ≤0.125 to ≥256 | 0.125 | 0.25 | 97.8 | 2.2 | - | 0.0 |
Colistin | ≤0.125 to ≥256 | 0.25 | 0.5 | - | - | 97.8 | 2.2 |
ESBL-producing K. pneumoniae (n = 6) g | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | - | - | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | - | - | 100.0 | 0.0 | - | 11.3 |
Ceftazidime | ≤0.125 to ≥256 | - | - | 33.3 | - | 0.0 | 66.7 |
Meropenem | ≤0.125 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Cefepime | ≤0.125 to ≥256 | - | - | 33.3 | 16.7 | - | 50.0 |
Colistin | ≤0.125 to ≥256 | - | - | - | - | 100.0 | 0.0 |
P. aeruginosa (n = 35) | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | 1.5 | 3.0 | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | 0.5 | 2.0 | 94.2 | - | 2.9 | 2.9 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | 16 | 256 | 62.9 | - | 8.6 | 28.5 |
Ceftazidime | ≤0.125 to ≥256 | 2 | 64 | 80.0 | - | 0.0 | 20.0 |
Meropenem | ≤0.125 to ≥256 | 2 | 64 | 65.7 | - | 8.6 | 25.7 |
Cefepime | ≤0.125 to ≥256 | 4 | 16 | 85.7 | - | 5.7 | 8.6 |
Colistin | ≤0.125 to ≥256 | 1 | 4 | - | - | 88.6 | 11.4 |
Enterobacter spp. (n = 9) g | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | - | - | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | - | - | 88.9 | 0.0 | - | 11.1 |
Ceftazidime | ≤0.125 to ≥256 | - | - | 88.9 | - | 0.0 | 11.1 |
Meropenem | ≤0.125 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Cefepime | ≤0.125 to ≥256 | - | - | 100.0 | 0.0 | - | 0.0 |
Colistin | ≤0.125 to ≥256 | - | - | - | - | 66.7 | 33.3 |
Non-MDR P. mirabilis, Proteus spp. (n = 11) | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | 0.094 | 0.125 | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | 0.75 | 1.5 | 90.9 | - | 0.0 | 9.1 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | 0.5 | 64 | 81.8 | 0.0 | - | 18.2 |
Ceftazidime | ≤0.125 to ≥256 | 0.125 | 16 | 81.8 | - | 0.0 | 18.2 |
Meropenem | ≤0.125 to ≥256 | 0.25 | 2 | 72.7 | - | 18.2 | 9.1 |
Cefepime | ≤0.125 to ≥256 | 0.125 | 1 | 90.9 | 12.5 | - | 9.1 |
Colistin | ≤0.125 to ≥256 | 256 | ≥256 | - | - | 9.1 | 90.9 |
ESBL-producing P. mirabilis, Proteus spp. (n = 5) g | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | - | - | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | - | - | 100.0 | 0.0 | - | 0.0 |
Ceftazidime | ≤0.125 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Meropenem | ≤0.125 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Cefepime | ≤0.125 to ≥256 | - | - | 40.0 | 40.0 | - | 20.0 |
Colistin | ≤0.125 to ≥256 | - | - | - | - | 0.0 | 100.0 |
Citrobacter spp. (n = 12) | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | 0.125 | 0.5 | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | 0.25 | 1.5 | 100.0 | - | 0.0 | 0.0 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | 2 | 16 | 83.4 | 8.3 | - | 8.3 |
Ceftazidime | ≤0.125 to ≥256 | 0.125 | 64 | 83.3 | - | 0.0 | 16.7 |
Meropenem | ≤0.125 to ≥256 | 0.125 | 0.5 | 100.0 | - | 0.0 | 0.0 |
Cefepime | ≤0.125 to ≥256 | 0.125 | 0.5 | 100.0 | 0.0 | - | 0.0 |
Colistin | ≤0.125 to ≥256 | 0.125 | 1 | - | - | 91.7 | 8.3 |
A. baumannii (n = 13) | |||||||
Ceftazidime-avibactam e | ≤0.016 to ≥256 | 2 | 4 | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam e | ≤0.016 to ≥256 | ≤0.016 | 4 | 61.5 | - | 38.5 | 0.0 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | 0.25 | 256 | 69.2 | - | 0.0 | 30.8 |
Ceftazidime | ≤0.125 to ≥256 | 2 | 16 | 84.6 | - | 7.7 | 7.7 |
Meropenem | ≤0.125 to ≥256 | 0.5 | 64 | 69.2 | - | 0.0 | 30.8 |
Cefepime | ≤0.125 to ≥256 | 1 | 256 | 69.2 | - | 7.7 | 23.1 |
Colistin | ≤0.125 to ≥256 | 0.25 | 0.5 | - | - | 100.0 | 0.0 |
S. maltophilia (n = 14) | |||||||
Ceftazidime-avibactam e | ≤0.016 to ≥256 | 24 | ≥256 | 28.6 | - | - | 71.4 |
Ceftolozane-tazobactam e | ≤0.016 to ≥256 | 96 | ≥256 | 14.3 | - | 21.4 | 64.3 |
Piperacillin-tazobactam f | ≤0.125 to ≥256 | ≥256 | ≥256 | 0.0 | - | 7.1 | 92.9 |
Ceftazidime | ≤0.125 to ≥256 | 32 | ≥256 | 21.4 | - | 14.3 | 64.3 |
Meropenem f | ≤0.125 to ≥256 | ≥256 | ≥256 | 0.0 | - | 0.0 | 100.0 |
Cefepime f | ≤0.125 to ≥256 | 64 | 256 | 0.0 | - | 21.4 | 78.6 |
Colistin e | ≤0.125 to ≥256 | 16 | 64 | - | - | 21.4 | 78.6 |
M. morganii (n = 7) g | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | - | - | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | - | - | 100.0 | 0.0 | - | 0.0 |
Ceftazidime | ≤0.125 to ≥256 | - | - | 71.4 | - | 28.6 | 0.0 |
Meropenem | ≤0.125 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Cefepime | ≤0.125 to ≥256 | - | - | 85.7 | 14.3 | - | 0.0 |
Colistin | ≤0.125 to ≥256 | - | - | - | - | 14.3 | 85.7 |
P. stuartii (n = 1) g | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | - | - | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | - | - | 100.0 | 0.0 | - | 0.0 |
Ceftazidime | ≤0.125 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Meropenem | ≤0.125 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Cefepime | ≤0.125 to ≥256 | - | - | 100.0 | 0.0 | - | 0.0 |
Colistin | ≤0.125 to ≥256 | - | - | - | - | 0.0 | 100.0 |
Serratia spp. (n = 2) g | |||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | - | - | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | - | - | 100.0 | 0.0 | - | 0.0 |
Ceftazidime | ≤0.125 to ≥256 | - | - | 50.0 | - | 0.0 | 50.0 |
Meropenem | ≤0.125 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Cefepime | ≤0.125 to ≥256 | - | - | 100.0 | 0.0 | - | 0.0 |
Colistin | ≤0.125 to ≥256 | - | - | - | - | 0.0 | 100.0 |
Aeromonas spp. (n = 2) g | |||||||
Ceftazidime-avibactam e | ≤0.016 to ≥256 | - | - | 100.0 | - | - | 0.0 |
Ceftolozane-tazobactam e | ≤0.016 to ≥256 | - | - | 50.0 | - | 50.0 | 0.0 |
Piperacillin-tazobactam | ≤0.125 to ≥256 | - | - | 50.0 | - | 0.0 | 50.0 |
Ceftazidime | ≤0.125 to ≥256 | - | - | 50.0 | - | 0.0 | 50.0 |
Meropenem | ≤0.125 to ≥256 | - | - | 50.0 | - | 0.0 | 50.0 |
Cefepime | ≤0.125 to ≥256 | - | - | 100.0 | - | 0.0 | 0.0 |
Colistin e | ≤0.125 to ≥256 | - | - | - | - | 100.0 | 0.0 |
Antimicrobial Agent a | MIC (mg/L) | Susceptibility c (%) | ||||
---|---|---|---|---|---|---|
Range | MIC50 b | MIC90 b | S | I | R | |
ESBL-producers (n = 32) | ||||||
K. pneumoniae (n = 32) | ||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | 0.19 | 0.5 | 100.0 | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | 0.38 | 0.75 | 100.0 | 0.0 | 0.0 |
CPE (n = 101) | ||||||
E. coli (n = 50) | ||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | ≥256 | ≥256 | 12.0 | - | 88.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | ≥256 | ≥256 | 10.0 | 2.0 | 88.0 |
Klebsiella spp. (n = 38) | ||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | 0.5 | ≥256 | 84.2 | - | 15.8 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | 12 | ≥256 | 42.1 | 0.0 | 57.9 |
Citrobacter spp. (n = 6) d | ||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | - | - | 50.0 | - | 50.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | - | - | 50.0 | 0.0 | 50.0 |
Enterobacter spp. (n = 7) d | ||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | - | - | 28.6 | - | 71.4 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | - | - | 28.6 | 0.0 | 71.4 |
Antimicrobial Agent a | MIC (mg/L) | Susceptibility c (%) | ||||
---|---|---|---|---|---|---|
Range | MIC50 b | MIC90 b | S | I | R | |
NDM-positive (n = 55) | ||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | ≥256 | ≥256 | 0.0 | - | 100.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | ≥256 | ≥256 | 0.0 | 0.0 | 100.0 |
OXA-positive (n = 34) | ||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | 0.25 | 0.75 | 97.1 | - | 2.9 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | 1.5 | 24 | 76.5 | 2.9 | 20.6 |
NDM+OXA-positive (n = 2) d | ||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | - | - | 0.0 | - | 100.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | - | - | 0.0 | 0.0 | 100.0 |
KPC-positive (n = 10) | ||||||
Ceftazidime-avibactam | ≤0.016 to ≥256 | 1 | 1.5 | 100.0 | - | 0.0 |
Ceftolozane-tazobactam | ≤0.016 to ≥256 | 48 | 64 | 0.0 | 0.0 | 100.0 |
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Teng, J.L.L.; Chan, E.; Li, T.T.; Kwan, T.Y.; Chan, K.F.; Li, W.H.; Tang, V.W.K.; Yeung, M.L.; Lau, S.K.P.; Woo, P.C.Y. Antibiotic Susceptibility of Aerobic and Facultative Anaerobic Gram-Negative Rods in Hong Kong and Implications on Usefulness of Ceftazidime-Avibactam and Ceftolozane-Tazobactam. Antibiotics 2024, 13, 802. https://doi.org/10.3390/antibiotics13090802
Teng JLL, Chan E, Li TT, Kwan TY, Chan KF, Li WH, Tang VWK, Yeung ML, Lau SKP, Woo PCY. Antibiotic Susceptibility of Aerobic and Facultative Anaerobic Gram-Negative Rods in Hong Kong and Implications on Usefulness of Ceftazidime-Avibactam and Ceftolozane-Tazobactam. Antibiotics. 2024; 13(9):802. https://doi.org/10.3390/antibiotics13090802
Chicago/Turabian StyleTeng, Jade L. L., Elaine Chan, Tsz Tuen Li, Tsz Ying Kwan, Ka Fai Chan, Wing Ho Li, Viki W. K. Tang, Man Lung Yeung, Susanna K. P. Lau, and Patrick C. Y. Woo. 2024. "Antibiotic Susceptibility of Aerobic and Facultative Anaerobic Gram-Negative Rods in Hong Kong and Implications on Usefulness of Ceftazidime-Avibactam and Ceftolozane-Tazobactam" Antibiotics 13, no. 9: 802. https://doi.org/10.3390/antibiotics13090802