In Vitro Activity of Ceftazidime-Avibactam against Carbapenem-Resistant and Hypervirulent Klebsiella pneumoniae Isolates

Fangyou Yu; Jingnan Lv; Siqiang Niu; Hong Du; Yi-Wei Tang; Robert A Bonomo; Barry N Kreiswirth; Liang Chen

doi:10.1128/AAC.01031-18

In Vitro Activity of Ceftazidime-Avibactam against Carbapenem-Resistant and Hypervirulent Klebsiella pneumoniae Isolates

Antimicrob Agents Chemother. 2018 Jul 27;62(8):e01031-18. doi: 10.1128/AAC.01031-18. Print 2018 Aug.

Authors

Fangyou Yu^#^{1

2}, Jingnan Lv^#², Siqiang Niu^#³, Hong Du⁴, Yi-Wei Tang^{5

6}, Robert A Bonomo^{7

8

9

10

11}, Barry N Kreiswirth¹², Liang Chen¹³

Affiliations

¹ Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
² Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
³ Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁴ Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
⁵ Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
⁶ Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, New York, USA.
⁷ Case VA Center for Antimicrobial Resistance and Epidemiology (CARES), Case Western Reserve University, Cleveland, Ohio, USA.
⁸ Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA.
⁹ Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
¹⁰ Department of Pharmacology, Case Western Reserve University, Cleveland, Ohio, USA.
¹¹ Department of Molecular Biology and Microbiology, Case Western Reserve University, Cleveland, Ohio, USA.
¹² Public Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA.
¹³ Public Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA Chen11@njms.rutgers.edu.

^# Contributed equally.

Abstract

Carbapenem-resistant and hypervirulent Klebsiella pneumoniae (CR-hvKp) strains have emerged while antimicrobial treatment options remain limited. Herein, we tested the in vitro activity of ceftazidime-avibactam and other comparator antibiotics against 65 CR-hvKp isolates. Ceftazidime-avibactam, colistin, and tigecycline are highly active in vitro against CR-hvKp isolates (MIC₉₀, ≤1 μg/ml), including K. pneumoniae carbapenemase 2 (KPC-2)-producing ST11 CR-hvKp. On the basis of previous clinical experience and the in vitro data presented herein, we posit that ceftazidime-avibactam is a therapeutic option against CR-hvKp infections.

Keywords: carbapenem resistance; ceftazidime-avibactam; hypervirulent Klebsiella pneumoniae; susceptibility.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Anti-Bacterial Agents / pharmacology
Azabicyclo Compounds / pharmacology*
Bacterial Proteins / genetics
Bacterial Proteins / metabolism
Carbapenems / pharmacology*
Ceftazidime / pharmacology*
Drug Combinations
Klebsiella pneumoniae / drug effects*
Klebsiella pneumoniae / genetics
Microbial Sensitivity Tests
beta-Lactamases / genetics
beta-Lactamases / metabolism

Substances

Anti-Bacterial Agents
Azabicyclo Compounds
Bacterial Proteins
Carbapenems
Drug Combinations
avibactam, ceftazidime drug combination
Ceftazidime
beta-Lactamases
carbapenemase-2, Klebsiella pneumoniae

Abstract

Publication types

MeSH terms

Substances

Grants and funding