In Vitro Effect of Ceftazidime-Avibactam by Synergy Testing with Aztreonam using Disc E Strip Method - Contribution of Promising Combination in the Era of Antibiotic Resistance
- 1. Post Graduate, Department of Microbiology, Bangalore Medical College and Research Institute
- 2. Professor, Department of Microbiology, Bangalore Medical College and Research Institute
- 3. Lecturer, Department of Microbiology, Bangalore Medical College and Research Institute
Description
Introduction: Carbapenem resistant Enterobacterales (CRE) is a rapidly unfolding concern in the realm of public health. Ceftazidime-Avibactam combination has excellent in vitro activity against Gram negative pathogens showing promising results with Aztreonam. Objective: To determine the phenotypic synergy of Ceftazidime-Avibactam with Aztreonam in Carbapenem resistant Enterobacterales. Methodology: 100 Carbapenem resistant Enterobacterales were included in the study and tested for Ceftazidime-Avibactam (CZA) sensitivity by Vitek2 using Critical Alert cards. Phenotypic synergy testing of CZA resistant isolates with Aztreonam (ATM) was done by Disc-E strip method. ATM discs were placed 15mm away from centre of CZA strip and incubated overnight at 37°C. Reduction in MIC of CZA by ≥3 folds and zone of inhibition around ATM >21mm was reported as synergy positive. Isolates were further tested for presence of genes coding for bla-NDM and bla-OXA-48 by conventional PCR. Results: 62/100 (62%) isolates were Klebsiella pneumoniae and 38/100 (38%) were Escherichia coli. 61/62 (98%) Klebsiella pneumoniae and 36/38 (94%) Escherichia coli isolates were synergy positive. 1 (2%) Klebsiella pneumoniae and 2 (6%) Escherichia coli were synergy negative. PCR identified bla-NDM gene in 46(46%), bla-OXA-48 in 21(21%), co-production of both in 27(27%) isolates. 6(6%) isolates were negative for both genes. Conclusion: Multidrug resistance is a threat to mankind and this combination of Ceftazidime-Avibactam with Aztreonam will help in combating this problem.
Abstract (English)
Introduction: Carbapenem resistant Enterobacterales (CRE) is a rapidly unfolding concern in the realm of public health. Ceftazidime-Avibactam combination has excellent in vitro activity against Gram negative pathogens showing promising results with Aztreonam. Objective: To determine the phenotypic synergy of Ceftazidime-Avibactam with Aztreonam in Carbapenem resistant Enterobacterales. Methodology: 100 Carbapenem resistant Enterobacterales were included in the study and tested for Ceftazidime-Avibactam (CZA) sensitivity by Vitek2 using Critical Alert cards. Phenotypic synergy testing of CZA resistant isolates with Aztreonam (ATM) was done by Disc-E strip method. ATM discs were placed 15mm away from centre of CZA strip and incubated overnight at 37°C. Reduction in MIC of CZA by ≥3 folds and zone of inhibition around ATM >21mm was reported as synergy positive. Isolates were further tested for presence of genes coding for bla-NDM and bla-OXA-48 by conventional PCR. Results: 62/100 (62%) isolates were Klebsiella pneumoniae and 38/100 (38%) were Escherichia coli. 61/62 (98%) Klebsiella pneumoniae and 36/38 (94%) Escherichia coli isolates were synergy positive. 1 (2%) Klebsiella pneumoniae and 2 (6%) Escherichia coli were synergy negative. PCR identified bla-NDM gene in 46(46%), bla-OXA-48 in 21(21%), co-production of both in 27(27%) isolates. 6(6%) isolates were negative for both genes. Conclusion: Multidrug resistance is a threat to mankind and this combination of Ceftazidime-Avibactam with Aztreonam will help in combating this problem.
Files
IJPCR,Vol16,Issue6,Article237.pdf
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Additional details
Dates
- Accepted
-
2024-05-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue6,Article237.pdf
- Development Status
- Active
References
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