BibTex format
@article{Rawson:2022:10.1016/j.jgar.2022.01.025,
author = {Rawson, TM and Brzeska-Trafny, I and Maxfield, R and Almeida, M and Gilchrist, M and Gonzalo, X and Moore, L and Donaldson, H and Davies, F},
doi = {10.1016/j.jgar.2022.01.025},
journal = {Journal of Global Antimicrobial Resistance},
pages = {558--562},
title = {A practical laboratory method to determine ceftazidime-avibactam-aztreonam synergy in patients with New Delhi Metallo-beta-lactamase (NDM) producing Enterobacterales infection},
url = {http://dx.doi.org/10.1016/j.jgar.2022.01.025},
volume = {29},
year = {2022}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Background:In response to infection with New Delhi Metallo-beta-lactamase (NDM) producing Enterobacterales, combination antimicrobial therapy with ceftazidime/avibactam (CAZ/AVI) plus aztreonam (ATM) has been explored. This study evaluated a practical laboratory method of testing for clinically significant synergy between CAZ/AVI+ATM in NDM producing Enterobacterales.Methods:Minimum inhibitory concentration (MIC) of clinical NDM producing isolates were determined for ATM alone and CAZ/AVI+ATM using broth dilution. Restoration of ATM breakpoint following the addition of CAZ/AVI was explored. A CAZ/AVI E-test/ATM disc method was compared to broth dilution.Results:Of 43 isolates, 33/43 (77%) isolates were ATM resistant (median [range] MIC=56 [16 – 512] mg/L). Addition of CAZ/AVI restored the ATM breakpoint (MIC <4mg/L) in 29/33 (89%) of resistant isolates. Overall, the E-test/disc method correlated with findings from broth dilution in 35/43 (81%) of cases. E-test/disc sensitivity was 77% and specificity 85%. Positive predictive value was 92% and negative predictive value 61%.Conclusion:CAZ/AVI+ATM demonstrated significant synergy in most ATM resistant NDM producing Enterobacterales. The E-test/disc method is a quick, reproducible, and reliable method of testing for clinically relevant synergy in the microbiology laboratory.
AU - Rawson,TM
AU - Brzeska-Trafny,I
AU - Maxfield,R
AU - Almeida,M
AU - Gilchrist,M
AU - Gonzalo,X
AU - Moore,L
AU - Donaldson,H
AU - Davies,F
DO - 10.1016/j.jgar.2022.01.025
EP - 562
PY - 2022///
SN - 2213-7165
SP - 558
TI - A practical laboratory method to determine ceftazidime-avibactam-aztreonam synergy in patients with New Delhi Metallo-beta-lactamase (NDM) producing Enterobacterales infection
T2 - Journal of Global Antimicrobial Resistance
UR - http://dx.doi.org/10.1016/j.jgar.2022.01.025
UR - http://hdl.handle.net/10044/1/95064
VL - 29
ER -
