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Simon, Michaela ; Gerlach, Roman G. ; Pfeifer, Yvonne ; Pfennigwerth, Niels ; Gatermann, Sören G. ; Schröder, Agnes ; Hiergeist, Andreas ; Hamprecht, Axel ; Rügamer, Tamara ; Gessner, André ; Jantsch, Jonathan

Increased zinc levels facilitate phenotypic detection of ceftazidime-avibactam resistance in metallo-β-lactamase-producing Gram-negative bacteria.

Simon, Michaela, Gerlach, Roman G., Pfeifer, Yvonne, Pfennigwerth, Niels, Gatermann, Sören G., Schröder, Agnes , Hiergeist, Andreas , Hamprecht, Axel, Rügamer, Tamara, Gessner, André and Jantsch, Jonathan (2022) Increased zinc levels facilitate phenotypic detection of ceftazidime-avibactam resistance in metallo-β-lactamase-producing Gram-negative bacteria. Frontiers in microbiology 13, p. 977330.

Date of publication of this fulltext: 14 Dec 2022 13:14
Article
DOI to cite this document: 10.5283/epub.53415


Abstract

Ceftazidime-avibactam is one of the last resort antimicrobial agents for the treatment of carbapenem-resistant, Gram-negative bacteria. Metallo-beta-lactamase-producing bacteria are considered to be ceftazidime-avibactam resistant. Here, we evaluated a semi-automated antimicrobial susceptibility testing system regarding its capability to detect phenotypic ceftazidime-avibactam resistance in 176 ...

Ceftazidime-avibactam is one of the last resort antimicrobial agents for the treatment of carbapenem-resistant, Gram-negative bacteria. Metallo-beta-lactamase-producing bacteria are considered to be ceftazidime-avibactam resistant. Here, we evaluated a semi-automated antimicrobial susceptibility testing system regarding its capability to detect phenotypic ceftazidime-avibactam resistance in 176 carbapenem-resistant, metallo-beta-lactamase-producing Enterobacterales and Pseudomonas aeruginosa isolates. Nine clinical isolates displayed ceftazidime-avibactam susceptibility in the semi-automated system and six of these isolates were susceptible by broth microdilution, too. In all nine isolates, metallo-beta-lactamase-mediated hydrolytic activity was demonstrated with the EDTA-modified carbapenemase inactivation method. As zinc is known to be an important co-factor for metallo-beta-lactamase activity, test media of the semi-automated antimicrobial susceptibility testing system and broth microdilution were supplemented with zinc. Thereby, the detection of phenotypic resistance was improved in the semi-automated system and in broth microdilution. Currently, ceftazidime-avibactam is not approved as treatment option for infections by metallo-beta-lactamase-producing, Gram-negative bacteria. In infections caused by carbapenem-resistant Gram-negatives, we therefore recommend to rule out the presence of metallo-beta-lactamases with additional methods before initiating ceftazidime-avibactam treatment.



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Details

Item typeArticle
Journal or Publication TitleFrontiers in microbiology
Publisher:Frontiers
Open Access Type:Gold (with APC)
Place of Publication:LAUSANNE
Volume:13
Page Range:p. 977330
Date22 November 2022
InstitutionsMedicine > Lehrstuhl für Kieferorthopädie
Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene
Identification Number
ValueType
36483203PubMed ID
10.3389/fmicb.2022.977330DOI
KeywordsEnterobacterales; Pseudomonas aeruginosa; metallo-beta-lactamases; ceftazidime-avibactam; zinc; antimicrobial susceptibility testing; Phoenix; Micronaut
Dewey Decimal Classification600 Technology > 610 Medical sciences Medicine
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgPartially
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-534157
Item ID53415

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