Synergistic Effect of Clinically Available Beta-Lactamase Inhibitors Combined with Cefiderocol against Carbapenemase-Producing Gram-Negative Organisms.

Détails

Ressource 1Télécharger: antibiotics-11-01681.pdf (600.49 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_E4954A14547F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Synergistic Effect of Clinically Available Beta-Lactamase Inhibitors Combined with Cefiderocol against Carbapenemase-Producing Gram-Negative Organisms.
Périodique
Antibiotics
Auteur⸱e⸱s
Bianco G., Gaibani P., Comini S., Boattini M., Banche G., Costa C., Cavallo R., Nordmann P.
ISSN
2079-6382 (Print)
ISSN-L
2079-6382
Statut éditorial
Publié
Date de publication
22/11/2022
Peer-reviewed
Oui
Volume
11
Numéro
12
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
The role of β-lactamases in reduced susceptibility or resistance to cefiderocol has been supported by recent reports. The purpose of this study was to investigate the in vitro impact of clinically available β-lactamase inhibitors on cefiderocol activity against characterized carbapenemase-producing Gram-negative isolates. A collection of 39 well-characterized Gram-negative isolates obtained from various clinical sources and countries were included. Cefiderocol antimicrobial susceptibility was evaluated via reference broth microdilution. The chequerboard microdilution method and time-kill assays were used to determine the synergy of tazobactam, avibactam, vaborbactam and relebactam in combination with cefiderocol. MICs of cefiderocol presented a 4- to 256-fold reduction against Klebsiella pneumoniae carbapenemase (KPC)-producing Gram-negative isolates (predominantly K. pneumoniae) when avibactam, vaborbactam and relebactam were combined individually. Notably, the KPC-inhibitors led to a 4- to 32-fold reduction in cefiderocol MICs in the four cefiderocol-resistant KPC-producing K. pneumoniae isolates, showing restoration of cefiderocol susceptibility (MIC ≤ 2 mg/L) in ten out of twelve cases. Tazobactam led to a 4- to 64-fold decrease in cefiderocol MICs only in K. pneumoniae strains harbouring bla <sub>KPC-41</sub> , bla <sub>KPC-31</sub> , bla <sub>KPC-53</sub> and bla <sub>KPC-66</sub> . The synergistic effect of all serine-β-lactamase inhibitors on cefiderocol activity was also shown in OXA-48-like-producing Enterobacterales strains. Conversely, a combination of β-lactamases inhibitors with cefiderocol was not synergistic with all OXA-23-like-producing strains and most metallo-β-lactamases producers. In conclusion, the addition of clinically available serine β-lactamase inhibitors to cefiderocol might represent an important development in the formulation to increase its spectrum and therapeutic efficacy, and to limit in vivo resistance emergence.
Mots-clé
avibactam, cefiderocol, relebactam, synergism, vaborbactam, β-lactamase inhibitor
Pubmed
Web of science
Open Access
Oui
Création de la notice
17/02/2023 9:32
Dernière modification de la notice
11/11/2023 7:22
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