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In Vitro Activity of Ceftolozane-Tazobactam Against Enterobacterales and Pseudomonas Aeruginosa Causing Urinary, Intra-Abdominal and Lower Respiratory Tract Infections in Intensive Care Units in Portugal: the STEP Multicenter Study

2020Journal article Open access
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dc.contributor.authorGarcía-Fernández, S
dc.contributor.authorGarcía-Castillo, M
dc.contributor.authorMelo-Cristino, J
dc.contributor.authorPinto, M
dc.contributor.authorGonçalves, E
dc.contributor.authorAlves, V
dc.contributor.authorVieira, AR
dc.contributor.authorRamalheira, E
dc.contributor.authorSancho, L
dc.contributor.authorDiogo, J
dc.contributor.authorFerreira, R
dc.contributor.authorSilva, D
dc.contributor.authorChaves, C
dc.contributor.authorPássaro, L
dc.contributor.authorPaixão, L
dc.date.accessioned2022-02-01T15:55:05Z
dc.date.available2022-02-01T15:55:05Z
dc.date.issued2020
dc.description.abstractThe STEP surveillance study was designed to increase knowledge about distribution of multidrug-resistant (MDR) Enterobacterales and Pseudomonas aeruginosa in Portugal, focusing on the intensive care unit (ICU). Antimicrobial susceptibility of common agents was also evaluated and compared with that of one of the latest therapeutic introductions, ceftolozane-tazobactam (C/T). Clinical isolates of Enterobacterales (n=426) and P. aeruginosa (n=396) from patients admitted in Portuguese ICUs were included. Activity of C/T and comparators was investigated using standard broth microdilution. Isolates were recovered from urinary tract (UTI, 36.9%), intra-abdominal (IAI, 24.2%) and lower respiratory tract (LRTI, 38.9%) infections. In P. aeruginosa, overall distribution of MDR/extremely-drug resistant (XDR)/pan-drug resistant (PDR) isolates accounted for 21.2%, 23.2% and 0.8%, respectively. C/T was the most potent agent tested against P. aeruginosa and MDR/XDR/PDR phenotypes. In Escherichia coli, extended-spectrum beta-lactamases (ESBL) and carbapenemase (CP) phenotypes accounted for 16.6% and 1.7%, respectively, whereas in Klebsiella spp., ESBL and CP-phenotypes represented 28.5% and 17.9%, respectively. Overall, susceptibility of C/T against Enterobacterales was 86.9%. C/T was the least affected agent in E. coli (99.4% susceptibility), whereas its activity was moderate in Klebsiella spp. (71.5%) and Enterobacter spp. (70.4%), due in part to a high rate of ESBL and CP-phenotypes. In Enterobacterales, blaKPC was the most prevalent CP gene (63.0%), followed by blaOXA-48 (33.3%) and blaVIM (3.7%). These microbiological results reinforce C/T as a therapeutic option in ICU patients with UTI, IAI or LRTI due to P. aeruginosa or Enterobacterales isolates, but not for CP producers.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInt J Antimicrob Agents. 2020 Mar;55(3):105887.pt_PT
dc.identifier.doi10.1016/j.ijantimicag.2020.105887.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3969
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectCHLC PAT CLINpt_PT
dc.subjectAnti-Bacterial Agents / pharmacology*pt_PT
dc.subjectAnti-Bacterial Agents / therapeutic usept_PT
dc.subjectCephalosporins / pharmacology*pt_PT
dc.subjectCephalosporins / therapeutic usept_PT
dc.subjectDrug Resistance, Multiple, Bacterial / drug effectspt_PT
dc.subjectEnterobacteriaceae / drug effects*pt_PT
dc.subjectEnterobacteriaceae Infections / drug therapy*pt_PT
dc.subjectEnterobacteriaceae Infections / microbiologypt_PT
dc.subjectHumanspt_PT
dc.subjectPortugalpt_PT
dc.subjectIntensive Care Unitspt_PT
dc.subjectIntraabdominal Infections / drug therapy*pt_PT
dc.subjectPseudomonas Infections / drug therapy*pt_PT
dc.subjectPseudomonas Infections / microbiologypt_PT
dc.subjectPseudomonas aeruginosa / drug effects*pt_PT
dc.subjectRespiratory Tract Infections / drug therapy*pt_PT
dc.subjectTazobactam / pharmacology*pt_PT
dc.subjectTazobactam / therapeutic usept_PT
dc.subjectUrinary Tract Infections / drug therapy*pt_PT
dc.titleIn Vitro Activity of Ceftolozane-Tazobactam Against Enterobacterales and Pseudomonas Aeruginosa Causing Urinary, Intra-Abdominal and Lower Respiratory Tract Infections in Intensive Care Units in Portugal: the STEP Multicenter Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue3pt_PT
oaire.citation.startPage105887pt_PT
oaire.citation.titleInternational Journal of Antimicrobial Agentspt_PT
oaire.citation.volume55pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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