Antimicrobial activity of ceftolozane-tazobactam tested against gram-negative contemporary (2015-2017) isolates from hospitalized patients with pneumonia in US medical centers

Diagn Microbiol Infect Dis. 2019 May;94(1):93-102. doi: 10.1016/j.diagmicrobio.2018.11.021. Epub 2018 Nov 30.

Abstract

Pseudomonas aeruginosa (n = 1531) and Enterobacteriaceae (n = 2373) clinical isolates from hospitalized patients with pneumonia were collected from 31 US medical centers during 2015-2017. Isolates were susceptibility tested against ceftolozane-tazobactam and comparators by broth microdilution. Results from intensive care unit (ICU) patients and patients with ventilator-associated bacterial pneumonia (VABP) were analyzed separately. Ceftolozane-tazobactam was very active against P. aeruginosa (MIC50/90, 0.5/2 mg/L; 97.5% susceptible), including multidrug-resistant (87.9% susceptible) and extensively drug-resistant (82.9% susceptible). Ceftolozane-tazobactam inhibited 90.3% of Enterobacteriaceae isolates (MIC50/90, 0.25/2 mg/L), including non-carbapenem-resistant Enterobacteriaceae isolates with an extended-spectrum β-lactamase phenotype (85.7% susceptible). Ceftolozane-tazobactam activity was stable against P. aeruginosa regardless of the US census division or ICU and VABP subsets (>90%); small differences were noted among Enterobacteriaceae isolates from the Middle Atlantic (range 78.3-88.9%) and West South Central (range 86.4-89.2%) divisions. These in vitro results indicate that ceftolozane-tazobactam may represent a valuable option for hospital-acquired bacterial pneumonia and VABP caused by Enterobacteriaceae and P. aeruginosa in the United States.

Keywords: E. coli; ESBL; Enterobacteriaceae; Klebsiella pneumoniae; MDR; Multidrug resistance; Pseudomonas aeruginosa.

MeSH terms

  • Academic Medical Centers
  • Anti-Bacterial Agents / pharmacology*
  • Cephalosporins / pharmacology*
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / isolation & purification
  • Gram-Negative Bacterial Infections / microbiology*
  • Hospitalization
  • Humans
  • Microbial Sensitivity Tests
  • Pneumonia, Bacterial / microbiology*
  • Pseudomonas aeruginosa / drug effects*
  • Pseudomonas aeruginosa / isolation & purification
  • Tazobactam / pharmacology*
  • United States
  • beta-Lactamase Inhibitors / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • beta-Lactamase Inhibitors
  • ceftolozane, tazobactam drug combination
  • Tazobactam