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

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_E4954A14547F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Synergistic Effect of Clinically Available Beta-Lactamase Inhibitors Combined with Cefiderocol against Carbapenemase-Producing Gram-Negative Organisms.
Journal
Antibiotics
Author(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
Publication state
Published
Issued date
22/11/2022
Peer-reviewed
Oui
Volume
11
Number
12
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
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.
Keywords
avibactam, cefiderocol, relebactam, synergism, vaborbactam, β-lactamase inhibitor
Pubmed
Web of science
Open Access
Yes
Create date
17/02/2023 10:32
Last modification date
11/11/2023 8:22
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