In vitro activity of imipenem/relebactam and comparators against Enterobacterales isolates collected in Brazilian hospitals according to results from the Study for Monitoring Antimicrobial Resistance Trends, 2020–2021

ABSTRACT The Study for Monitoring Antimicrobial Resistance Trends (SMART) surveillance program tested imipenem/relebactam (IMR) and comparators against a total of 2,258 non-duplicate clinical isolates of Enterobacterales (Klebsiella pneumoniae and Escherichia coli) collected across six Brazilian cit...

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Main Authors: Amanda Azevedo Bittencourt, Vinicius Lima Faustino, Paula de Mendonça Batista, Lays Paulino Leonel, Marina Della Negra de Paula, Thales José Polis
Format: Article
Language:English
Published: American Society for Microbiology 2025-07-01
Series:Microbiology Spectrum
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Online Access:https://journals.asm.org/doi/10.1128/spectrum.02543-24
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author Amanda Azevedo Bittencourt
Vinicius Lima Faustino
Paula de Mendonça Batista
Lays Paulino Leonel
Marina Della Negra de Paula
Thales José Polis
author_facet Amanda Azevedo Bittencourt
Vinicius Lima Faustino
Paula de Mendonça Batista
Lays Paulino Leonel
Marina Della Negra de Paula
Thales José Polis
author_sort Amanda Azevedo Bittencourt
collection DOAJ
description ABSTRACT The Study for Monitoring Antimicrobial Resistance Trends (SMART) surveillance program tested imipenem/relebactam (IMR) and comparators against a total of 2,258 non-duplicate clinical isolates of Enterobacterales (Klebsiella pneumoniae and Escherichia coli) collected across six Brazilian cities during 2020–2021. Antimicrobial susceptibility was determined by the Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution method and interpreted following Brazilian Committee on Antimicrobial Susceptibility (BrCAST)/European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints. Enterobacterales isolates were screened for β-lactamase genes (bla) by sequencing. The most frequent isolates identified among Enterobacterales were E. coli (n = 471; 20.9%) and K. pneumoniae (n = 453; 20.1%). Susceptibility testing showed that >99% of E. coli isolates were susceptible to colistin ([COL], n = 470; 99.8%), meropenem ([MEM], n = 468; 99.4%), IMR (n = 468; 99.4%), and ceftazidime/avibactam ([CZA], n = 468; 99.4%), whereas a high proportion of E. coli multidrug-resistant (MDR) isolates were susceptible to COL (n = 69; 98.6%), CZA (n = 67; 95.7%), MEM (n = 67; 95.7%), IMR (n = 67; 95.7%), and amikacin ([AMK], n = 66; 94.3%). Overall, K. pneumoniae isolates were most susceptible to CZA (n = 414; 91.4%) and IMR (n = 411; 90.7%) and over 86.0% of K. pneumoniae MDR isolates were susceptible to CZA (n = 268; 87.3%) and IMR (n = 265; 86.3%). This study reported that IMR was one of the most effective in vitro β-lactam–β-lactamase inhibitor combinations tested and demonstrated comparable activity to CZA and higher activity than COL against both the Enterobacterales species tested.IMPORTANCEAs new mechanisms of antibiotic resistance continue to emerge, especially with the rise of carbapenem resistance, this study emphasizes the importance of assessing the current landscape of antimicrobial resistance to identify optimal therapeutic approaches. In this way, the publication of national data is significant for understanding local epidemiology to evaluate new drugs and make the best choice among the antimicrobials available in the hospital environment, both for critically ill patients with resistant bacterial infections.
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spelling doaj-art-2b51c32dc50d4a06a1bd13baccbea8f32025-07-01T13:01:37ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972025-07-0113710.1128/spectrum.02543-24In vitro activity of imipenem/relebactam and comparators against Enterobacterales isolates collected in Brazilian hospitals according to results from the Study for Monitoring Antimicrobial Resistance Trends, 2020–2021Amanda Azevedo Bittencourt0Vinicius Lima Faustino1Paula de Mendonça Batista2Lays Paulino Leonel3Marina Della Negra de Paula4Thales José Polis5Global Medical & Scientific Affairs (GMSA), MSD Brazil, São Paulo, BrazilGlobal Medical & Scientific Affairs (GMSA), MSD Brazil, São Paulo, BrazilGlobal Medical & Scientific Affairs (GMSA), MSD Brazil, São Paulo, BrazilReal World Evidence, IQVIA Brazil, São Paulo, BrazilGlobal Medical & Scientific Affairs (GMSA), MSD Brazil, São Paulo, BrazilGlobal Medical & Scientific Affairs (GMSA), MSD Brazil, São Paulo, BrazilABSTRACT The Study for Monitoring Antimicrobial Resistance Trends (SMART) surveillance program tested imipenem/relebactam (IMR) and comparators against a total of 2,258 non-duplicate clinical isolates of Enterobacterales (Klebsiella pneumoniae and Escherichia coli) collected across six Brazilian cities during 2020–2021. Antimicrobial susceptibility was determined by the Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution method and interpreted following Brazilian Committee on Antimicrobial Susceptibility (BrCAST)/European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints. Enterobacterales isolates were screened for β-lactamase genes (bla) by sequencing. The most frequent isolates identified among Enterobacterales were E. coli (n = 471; 20.9%) and K. pneumoniae (n = 453; 20.1%). Susceptibility testing showed that >99% of E. coli isolates were susceptible to colistin ([COL], n = 470; 99.8%), meropenem ([MEM], n = 468; 99.4%), IMR (n = 468; 99.4%), and ceftazidime/avibactam ([CZA], n = 468; 99.4%), whereas a high proportion of E. coli multidrug-resistant (MDR) isolates were susceptible to COL (n = 69; 98.6%), CZA (n = 67; 95.7%), MEM (n = 67; 95.7%), IMR (n = 67; 95.7%), and amikacin ([AMK], n = 66; 94.3%). Overall, K. pneumoniae isolates were most susceptible to CZA (n = 414; 91.4%) and IMR (n = 411; 90.7%) and over 86.0% of K. pneumoniae MDR isolates were susceptible to CZA (n = 268; 87.3%) and IMR (n = 265; 86.3%). This study reported that IMR was one of the most effective in vitro β-lactam–β-lactamase inhibitor combinations tested and demonstrated comparable activity to CZA and higher activity than COL against both the Enterobacterales species tested.IMPORTANCEAs new mechanisms of antibiotic resistance continue to emerge, especially with the rise of carbapenem resistance, this study emphasizes the importance of assessing the current landscape of antimicrobial resistance to identify optimal therapeutic approaches. In this way, the publication of national data is significant for understanding local epidemiology to evaluate new drugs and make the best choice among the antimicrobials available in the hospital environment, both for critically ill patients with resistant bacterial infections.https://journals.asm.org/doi/10.1128/spectrum.02543-24antibioticsbacterial infectionsEnterobacteralesimipenem/relebactamsurveillance
spellingShingle Amanda Azevedo Bittencourt
Vinicius Lima Faustino
Paula de Mendonça Batista
Lays Paulino Leonel
Marina Della Negra de Paula
Thales José Polis
In vitro activity of imipenem/relebactam and comparators against Enterobacterales isolates collected in Brazilian hospitals according to results from the Study for Monitoring Antimicrobial Resistance Trends, 2020–2021
Microbiology Spectrum
antibiotics
bacterial infections
Enterobacterales
imipenem/relebactam
surveillance
title In vitro activity of imipenem/relebactam and comparators against Enterobacterales isolates collected in Brazilian hospitals according to results from the Study for Monitoring Antimicrobial Resistance Trends, 2020–2021
title_full In vitro activity of imipenem/relebactam and comparators against Enterobacterales isolates collected in Brazilian hospitals according to results from the Study for Monitoring Antimicrobial Resistance Trends, 2020–2021
title_fullStr In vitro activity of imipenem/relebactam and comparators against Enterobacterales isolates collected in Brazilian hospitals according to results from the Study for Monitoring Antimicrobial Resistance Trends, 2020–2021
title_full_unstemmed In vitro activity of imipenem/relebactam and comparators against Enterobacterales isolates collected in Brazilian hospitals according to results from the Study for Monitoring Antimicrobial Resistance Trends, 2020–2021
title_short In vitro activity of imipenem/relebactam and comparators against Enterobacterales isolates collected in Brazilian hospitals according to results from the Study for Monitoring Antimicrobial Resistance Trends, 2020–2021
title_sort in vitro activity of imipenem relebactam and comparators against enterobacterales isolates collected in brazilian hospitals according to results from the study for monitoring antimicrobial resistance trends 2020 2021
topic antibiotics
bacterial infections
Enterobacterales
imipenem/relebactam
surveillance
url https://journals.asm.org/doi/10.1128/spectrum.02543-24
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