Assessment of in vitro antimicrobial activities of ceftolozane/tazobactam and ceftazidime/avibactam against carbapenem-resistant Pseudomonas aeruginosa clinical isolates

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Salem D.; El-Shenawy A.; Dahroug H.; Zaiton M.; Gamal D.; Diab M.

Journal: BMC Infectious Diseases

Publisher: BioMed Central Ltd

Publication Date: 28 April 2025

Volume / Issue: Volume 25 / Issue 1

Article No.: 622

ISSN: 14712334

DOI: 10.1186/s12879-025-10891-w

Scopus: View on Scopus

PubMed: 40295988

Document Type: Article

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

Salem D., Microbiology Department, Theodor Bilharz Research Institute (TBRI), P.O Box 12411, Postal Address: 30 Imbaba, Giza, Egypt; El-Shenawy A., Microbiology Department, Theodor Bilharz Research Institute (TBRI), P.O Box 12411, Postal Address: 30 Imbaba, Giza, Egypt; Dahroug H., Microbiology Department, Theodor Bilharz Research Institute (TBRI), P.O Box 12411, Postal Address: 30 Imbaba, Giza, Egypt; Zaiton M., Microbiology Department, Theodor Bilharz Research Institute (TBRI), P.O Box 12411, Postal Address: 30 Imbaba, Giza, Egypt; Gamal D., Microbiology Department, Theodor Bilharz Research Institute (TBRI), P.O Box 12411, Postal Address: 30 Imbaba, Giza, Egypt; Diab M., Microbiology Department, Theodor Bilharz Research Institute (TBRI), P.O Box 12411, Postal Address: 30 Imbaba, Giza, Egypt

Abstract

Background: Carbapenem resistant Pseudomonas aeruginosa (P. aeruginosa) is a global health concern that poses a challenge to treat in health care facilities. Ceftazidim/avibactam and ceftolozane/tazobactam have a potential role in treatment of multi-drug resistant phenotypes including carbapenem resistant P. aeruginosa. Therefore, we aimed to assess the in vitro antimicrobial activity of ceftazidime/avibactam and ceftolozane/tazobactam against carbapenem-resistant P. aeruginosa (CRPA) strains with different β-lactamase/carbapenemase genes. Methods: Sixty CRPA isolates identified from clinical samples were examined for antimicrobial susceptibility including ceftazidim/avibactam and ceftolozane/tazobactam by Vitek2 compact system, and carbapenemase production by modified carbapenem inactivation method (mCIM) test and carbapenemase producing genes by polymerase chain reaction (PCR). Results: Isolates were resistant to imipenem in 96.7% and meropenem in 88.3%. of isolates. Carbapenemase production by mCIM test was 70% compared to 73.3% by (PCR). Carbapenemase encoding genes blaNDM, blaVIM and blaOXA-48 were detected in 60%, 41.7% and 25% respectively while blaIMP and blaKPC weren’t identified in this study. Among CRPA, both ceftazidim/avibactam and ceftolozane/tazobactam; were sensitive in only 11.7% of the isolates. Resistance to ceftazidim/avibactam and ceftolozane/tazobactam in isolates owning blaNDM, blaVIM, blaOXA-48 and those having combined blaNDM, blaVIM and blaOXA-48 carbapenemase resistance genes were 97.2%, 92%, 100% and 100% respectively. Conclusion: Modified carbapenem inactivation method test gave satisfactory results and could be used as an alternative to expensive genotypic methods. Ceftazidim/avibactam and ceftolozane/tazobactam were unsuccessful against carbapenem resistant P. aeruginosa isolates carrying carbapenemase genes especially metallo-β lactamase genes. Therefore, it is essential to detect susceptibility patterns to newly introduced β-Lactam/β-Lactamase inhibitor combinations due to the emerging resistance to these therapeutics. © The Author(s) 2025.

Keywords

Carbapenem resistant P. aeruginosa; Ceftazidim/avibactam; Ceftolozane/tazobactam; Modified carbapenem inactivation method test; β-Lactam/β-Lactamase inhibitor combinations; Anti-Bacterial Agents; Azabicyclo Compounds; Bacterial Proteins; beta-Lactamases; Carbapenems; Ceftazidime; Cephalosporins; Drug Combinations; Drug Resistance, Multiple, Bacterial; Humans; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Pseudomonas Infections; Tazobactam; amikacin; avibactam plus ceftazidime; aztreonam; carbapenemase; cefepime; ceftolozane plus tazobactam; ceftriaxone; ciprofloxacin; extended spectrum beta lactamase; gentamicin; imipenem; meropenem; metallo beta lactamase; piperacillin plus tazobactam; ticarcillin; timentin; tobramycin; antiinfective agent; avibactam, ceftazidime drug combination; azabicyclo derivative; bacterial protein; beta lactamase; carbapenem derivative; ceftolozane, tazobactam drug combination; cephalosporin derivative; antibiotic sensitivity; antimicrobial activity; Article; bacterial gene; bacterial strain; bacterium isolation; blaIMP gene; blaKPC gene; blaNDM gene; blaOXA 48 gene; blaVIM gene; carbapenem resistant Pseudomonas aeruginosa; genotype; in vitro study; minimum inhibitory concentration; nonhuman; polymerase chain reaction; drug combination; drug effect; genetics; human; isolation and purification; microbial sensitivity test; microbiology; multidrug resistance; Pseudomonas infection

Citation Information

Scopus Citations: 5

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