Activity of β-Lactamase Inhibitor Combinations Against Enterobacterales Isolated from Patients with Intra-Abdominal Infection from United States Medical Centres (2019–2023)
<b>Objective</b>: To evaluate the antimicrobial susceptibility of Enterobacterales isolated from patients with intra-abdominal infections (IAI) in United States (US) medical centres. <b>Methods</b>: A total of 2036 isolates (1/patient) were consecutively collected from patien...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-05-01
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| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/14/6/544 |
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| Summary: | <b>Objective</b>: To evaluate the antimicrobial susceptibility of Enterobacterales isolated from patients with intra-abdominal infections (IAI) in United States (US) medical centres. <b>Methods</b>: A total of 2036 isolates (1/patient) were consecutively collected from patients with IAI in 63 US hospitals in 2019–2023 and susceptibility tested by broth microdilution. Carbapenem-resistant Enterobacterales (CRE) were screened for carbapenemases by whole genome sequencing. <b>Results</b>: The most common Enterobacterales species were <i>E. coli</i> (47.1%), <i>K. pneumoniae</i> (18.7%), and <i>E. cloacae</i> species complex (9.8%). The most active agents were aztreonam-avibactam (MIC<sub>50/90</sub>, ≤0.03/0.12 mg/L), ceftazidime-avibactam (MIC<sub>50/90</sub>, 0.12/0.25 mg/L), and meropenem-vaborbactam (MIC<sub>50/90</sub>, 0.03/0.06 mg/L) with 99.9% susceptibility. A multidrug-resistant (MDR) phenotype (nonsusceptibility to ≥3 classes) was observed in 21.4% of Enterobacterales (<i>n</i> = 436). Piperacillin-tazobactam was active against 87.2% of Enterobacterales overall and 50.2% of MDR isolates, and meropenem was active against 99.2% of Enterobacterales and 96.1% of MDR isolates. Only 51.6% of Enterobacterales were susceptible to ampicillin-sulbactam. An acquired broad-spectrum β-lactamase gene was identified in 207 (10.2%) isolates and included extended-spectrum β-lactamases (ESBL; <i>n</i> = 182), transferable AmpC (<i>n</i> = 24) and carbapenemases (<i>n</i> = 9). Eight isolates produced two β-lactamase classes. <b>Conclusions</b>: Aztreonam-avibactam, ceftazidime-avibactam, and meropenem-vaborbactam exhibited almost complete activity (99.9% susceptibility) against Enterobacterales causing IAI in US hospitals. In contrast, piperacillin-tazobactam exhibited limited activity against these organisms, especially those with a MDR phenotype. |
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| ISSN: | 2079-6382 |