TABLE 2.
Activities of ceftolozane, ceftozolane-tazobactam, and comparative agents against anaerobic isolates
| Species or group (na) | Antibiotic | MIC (μg/ml) |
% Resb | ||
|---|---|---|---|---|---|
| Range | 50% | 90% | |||
| Bacteroides caccae (21) | Ceftolozane | ≤0.125–≥256 | 64 | ≥256 | NA |
| Ceftolozane-tazobactam | ≤0.125–16 | 0.25 | 16 | NA | |
| Ampicillin-sulbactam | ≤0.5–8 | 1 | 4 | 0 | |
| Piperacillin-tazobactam | ≤0.5–16 | ≤0.5 | 16 | 0 | |
| Moxifloxacin | ≤0.5–>16 | 2 | >16 | 33.3 | |
| Linezolid | ≤0.5–8 | 1 | 2 | 4.8 | |
| Tigecycline | ≤0.06–16 | 0.5 | 4 | 4.8 | |
| Imipenem | ≤0.125–0.5 | ≤0.125 | 0.25 | 0 | |
| Meropenem | ≤0.125–8 | 0.25 | 2 | 0 | |
| Ertapenem | ≤0.125–2 | 0.25 | 2 | 0 | |
| Clindamycin | ≤0.5–>128 | ≤0.5 | >128 | 19.0 | |
| Metronidazole | 1–2 | 1 | 2 | 0 | |
| Parabacteroides distasonis (25) | Ceftolozane | 8–≥256 | ≥256 | ≥256 | NA |
| Ceftolozane-tazobactam | ≤0.125–16 | 16 | 32 | NA | |
| Ampicillin-sulbactam | 1–128 | 8 | 32 | 16 | |
| Piperacillin-tazobactam | ≤0.5–64 | 2 | 8 | 0 | |
| Moxifloxacin | ≤0.5–>16 | 2 | 8 | 20 | |
| Linezolid | ≤0.5–8 | 2 | 4 | 4 | |
| Tigecycline | 0.5–16 | 2 | 4 | 4 | |
| Imipenem | ≤0.125–8 | 0.25 | 1 | 0 | |
| Meropenem | ≤0.125–2 | 0.25 | 1 | 0 | |
| Ertapenem | ≤0.125–8 | 0.5 | 4 | 0 | |
| Clindamycin | ≤0.5–>128 | 16 | >128 | 44 | |
| Metronidazole | 1–2 | 1 | 2 | 0 | |
| Bacteroides fragilis (244) | Ceftolozane | ≤0.125–≥256 | 64 | ≥256 | NA |
| Ceftolozane-tazobactam | ≤0.125–≥256 | 1 | 4 | NA | |
| Ampicillin-sulbactam | ≤0.5–≥256 | 2 | 8 | 1.1 | |
| Piperacillin-tazobactam | ≤0.5–≥256 | ≤0.5 | 2 | 0.6 | |
| Moxifloxacin | ≤0.5–>16 | 1 | 8 | 8.8 | |
| Linezolid | ≤0.5–4 | 1 | 2 | 0 | |
| Tigecycline | ≤0.06–16 | ≤0.5 | 2 | 0.2 | |
| Imipenem | ≤0.125–16 | ≤0.125 | 0.5 | 0.6 | |
| Meropenem | ≤0.125–16 | ≤0.125 | 0.5 | 1.3 | |
| Ertapenem | ≤0.125–16 | 0.25 | 1 | 1.3 | |
| Clindamycin | ≤0.5–>128 | ≤0.5 | >128 | 10.5 | |
| Metronidazole | 1–2 | 1 | 2 | 0 | |
| Bacteroides ovatus (32) | Ceftolozane | 1–≥256 | ≥256 | ≥256 | NA |
| Ceftolozane-tazobactam | ≤0.125–≥256 | 4 | 32 | NA | |
| Ampicillin-sulbactam | ≤0.5–8 | 1 | 8 | 0 | |
| Piperacillin-tazobactam | ≤0.5–32 | 1 | 8 | 0 | |
| Moxifloxacin | ≤0.5–>16 | 4 | 16 | 43.8 | |
| Linezolid | ≤0.5–2 | 1 | 2 | 0 | |
| Tigecycline | ≤0.06–4 | 0.25 | 2 | 0 | |
| Imipenem | ≤0.125–2 | ≤0.125 | 0.25 | 0 | |
| Meropenem | ≤0.125–8 | ≤0.125 | 0.5 | 0 | |
| Ertapenem | ≤0.125–8 | 0.5 | 2 | 0 | |
| Clindamycin | ≤0.5–128 | 1 | 128 | 15.6 | |
| Metronidazole | 1–2 | 1 | 2 | 0 | |
| Bacteroides thetaiotaomicron (86) | Ceftolozane | 0.25–≥256 | ≥256 | ≥256 | NA |
| Ceftolozane-tazobactam | ≤0.125–128 | 4 | 32 | NA | |
| Ampicillin-sulbactam | ≤0.5–64 | 1 | 8 | 2.3 | |
| Piperacillin-tazobactam | ≤0.5–32 | 1 | 8 | 0 | |
| Moxifloxacin | ≤0.5–>16 | 2 | >16 | 32.6 | |
| Linezolid | ≤0.5–16 | 1 | 2 | 2.3 | |
| Tigecycline | ≤0.06–16 | 0.25 | 2 | 1.2 | |
| Imipenem | ≤0.125–4 | ≤0.125 | 0.5 | 0 | |
| Meropenem | ≤0.125–4 | ≤0.125 | 1 | 0 | |
| Ertapenem | ≤0.125–8 | 0.25 | 2 | 0 | |
| Clindamycin | ≤0.5–>128 | 1 | >128 | 29.1 | |
| Metronidazole | 1–2 | 1 | 2 | 0 | |
| Bacteroides uniformis (18) | Ceftolozane | 0.5–≥256 | 64 | ≥256 | NA |
| Ceftolozane-tazobactam | ≤0.125–32 | 2 | 16 | NA | |
| Ampicillin-sulbactam | ≤0.5–8 | 1 | 2 | 0 | |
| Piperacillin-tazobactam | ≤0.5–16 | 1 | 2 | 0 | |
| Moxifloxacin | ≤0.5–>16 | 1 | 4 | 11.1 | |
| Linezolid | ≤0.5–16 | 1 | 2 | 11.1 | |
| Tigecycline | ≤0.06–4 | 0.125 | 0.5 | 0 | |
| Imipenem | ≤0.125–0.25 | ≤0.125 | 0.25 | 0 | |
| Meropenem | ≤0.125–0.5 | ≤0.125 | 0.25 | 0 | |
| Ertapenem | ≤0.125–2 | 0.25 | 0.5 | 0 | |
| Clindamycin | ≤0.5–128 | 1 | >128 | 27.8 | |
| Metronidazole | 1–2 | 1 | 2 | 0 | |
| Bacteroides vulgatus (28) | Ceftolozane | 0.25–≥256 | 128 | ≥256 | NA |
| Ceftolozane-tazobactam | <0.125–≥256 | 4 | 32 | NA | |
| Ampicillin-sulbactam | ≤0.5–16 | 4 | 16 | 0 | |
| Piperacillin-tazobactam | ≤0.5–16 | 2 | 8 | 0 | |
| Moxifloxacin | ≤0.5–>16 | >16 | 32 | 75 | |
| Linezolid | <0.5–4 | 1 | 2 | 0 | |
| Tigecycline | ≤0.06–4 | 0.5 | 2 | 0 | |
| Imipenem | ≤0.125–0.5 | 0.25 | 0.5 | 0 | |
| Meropenem | ≤0.125–1 | 0.25 | 0.5 | 0 | |
| Ertapenem | ≤0.125–2 | 0.5 | 1 | 0 | |
| Clindamycin | ≤0.5–>128 | ≤0.5 | >128 | 39.3 | |
| Metronidazole | 1–2 | 1 | 2 | 0 | |
| Other Bacteroidesc (12) | Ceftolozane | 0.25–≥256 | 8 | ≥256 | NA |
| Ceftolozane-tazobactam | ≤0.125–128 | 0.25 | 8 | NA | |
| Ampicillin-sulbactam | ≤0.5–8 | 0.5 | 8 | 0 | |
| Piperacillin-tazobactam | ≤0.5–4 | 0.5 | 2 | 0 | |
| Moxifloxacin | ≤0.5–>16 | ≤0.5 | 8 | 25 | |
| Linezolid | ≤0.5–4 | 1 | 2 | 0 | |
| Tigecycline | ≤0.06–8 | 0.25 | 2 | 0 | |
| Imipenem | ≤0.125–0.5 | ≤0.125 | 0.25 | 0 | |
| Meropenem | ≤0.125–8 | 0.5 | 8 | 0 | |
| Ertapenem | ≤0.125–8 | 0.5 | 4 | 0 | |
| Clindamycin | ≤0.5–>128 | ≤0.5 | 1 | 0 | |
| Metronidazole | 1–2 | 1 | 2 | 0 | |
| Prevotella spp. (33) | Ceftolozane | ≤0.125–≥256 | 16 | ≥256 | NA |
| Ceftolozane-tazobactam | ≤0.125–4 | ≤0.125 | 1 | NA | |
| Ampicillin-sulbactam | ≤0.5–4 | 1 | 4 | 0 | |
| Piperacillin-tazobactam | ≤0.5–4 | 0.5 | 2 | 0 | |
| Moxifloxacin | ≤0.5–16 | 2 | 8 | 9.1 | |
| Linezolid | ≤0.5–8 | 2 | 4 | 3 | |
| Tigecycline | ≤0.06–4 | ≤0.5 | 1 | 0 | |
| Imipenem | All ≤0.125 | ≤0.125 | ≤0.125 | 0 | |
| Meropenem | ≤0.125–0.5 | ≤0.125 | 0.25 | 0 | |
| Clindamycin | ≤0.5–>128 | ≤0.5 | >128 | 21.2 | |
| Metronidazole | 1–2 | 1 | 2 | 0 | |
| Fusobacterium spp. (12) | Ceftolozane | ≤0.125–16 | ≤0.125 | 16 | NA |
| Ceftolozane-tazobactam | ≤0.125–0.25 | ≤0.125 | 0.25 | NA | |
| Ampicillin-sulbactam | ≤0.5–1 | ≤0.5 | 1 | 0 | |
| Piperacillin-tazobactam | ≤0.5–1 | ≤0.5 | 8 | 0 | |
| Moxifloxacin | ≤0.5–4 | ≤0.5 | 4 | 0 | |
| Linezolid | ≤0.5–2 | ≤0.5 | 2 | 0 | |
| Tigecycline | ≤0.06–0.125 | ≤0.06 | 0.125 | 0 | |
| Imipenem | All ≤0.125 | ≤0.125 | ≤0.125 | 0 | |
| Meropenem | All ≤0.125 | ≤0.125 | ≤0.125 | 0 | |
| Clindamycin | ≤0.5–2 | ≤0.5 | 2 | 0 | |
| Metronidazole | All 1 | 1 | 1 | 0 | |
| Clostridium difficile (30) | Ceftolozane | 32–≥256 | ≥256 | ≥256 | NA |
| Ceftolozane-tazobactam | 0.25–≥256 | ≥256 | ≥256 | NA | |
| Ampicillin-sulbactam | ≤0.5–16 | 1 | 4 | 0 | |
| Piperacillin-tazobactam | ≤0.5–128 | 8 | 16 | 3.3 | |
| Moxifloxacin | ≤0.5–>16 | 2 | >16 | 43.3 | |
| Linezolid | ≤0.5–4 | 1 | 2 | 0 | |
| Tigecycline | ≤0.06–4 | ≤0.06 | 1 | 0 | |
| Imipenem | ≤0.125–16 | 4 | 8 | 3.3 | |
| Meropenem | ≤0.125–8 | 2 | 2 | 0 | |
| Vancomycin | ≤0.125–8 | 2 | 4 | NA | |
| Clindamycin | 1–16 | 2 | 16 | 23.3 | |
| Metronidazole | 1–4 | 2 | 4 | 0 | |
| Clostridium perfringens (11) | Ceftolozane | 0.5–64 | 1 | 64 | NA |
| Ceftolozane-tazobactam | ≤0.125–32 | 0.25 | 32 | NA | |
| Ampicillin-sulbactam | ≤0.5–1 | ≤0.5 | 1 | 0 | |
| Piperacillin-tazobactam | ≤0.5–2 | ≤0.5 | 2 | 0 | |
| Moxifloxacin | ≤0.5–4 | 1 | 4 | 0 | |
| Linezolid | 1–4 | 2 | 4 | 0 | |
| Tigecycline | 0.125–8 | 0.5 | 8 | 0 | |
| Imipenem | ≤0.125–0.25 | ≤0.125 | 0.25 | 0 | |
| Meropenem | All ≤0.125 | ≤0.125 | ≤0.125 | 0 | |
| Vancomycin | 1–2 | 1 | 2 | NA | |
| Clindamycin | ≤0.5–4 | 2 | 4 | 0 | |
| Metronidazole | 1–2 | 1 | 2 | 0 | |
| Clostridium spp.d (13) | Ceftolozane | 0.5–≥256 | ≥ 256 | ≥256 | NA |
| Ceftolozane-tazobactam | ≤0.125–≥256 | 16 | ≥256 | NA | |
| Ampicillin-sulbactam | ≤0.5–4 | ≤0.5 | 1 | 0 | |
| Piperacillin-tazobactam | ≤0.5–4 | 2 | 4 | 0 | |
| Moxifloxacin | ≤0.5–4 | 1 | 2 | 0 | |
| Linezolid | ≤0.5–4 | 2 | 4 | 0 | |
| Tigecycline | 0.125–4 | 2 | 4 | 0 | |
| Imipenem | ≤0.125–4 | 1 | 4 | 0 | |
| Meropenem | ≤0.125–2 | 0.25 | 2 | 0 | |
| Vancomycin | ≤0.125–4 | 1 | 4 | NA | |
| Clindamycin | 1–16 | 2 | 4 | 7.7 | |
| Metronidazole | 1–4 | 2 | 4 | 0 | |
| Anaerobic Gram+ cocci (31) | Ceftolozane | ≤0.125–≥256 | 4 | 16 | NA |
| Ceftolozane-tazobactam | ≤0.125–64 | 2 | 8 | NA | |
| Ampicillin-sulbactam | ≤0.5–2 | ≤0.5 | 1 | 0 | |
| Piperacillin-tazobactam | ≤0.5–16 | ≤0.5 | 2 | 0 | |
| Moxifloxacin | ≤0.5–16 | ≤0.5 | 16 | 9.7 | |
| Linezolid | ≤0.5–4 | 1 | 2 | 0 | |
| Tigecycline | ≤0.06–1 | 0.125 | 0.5 | 0 | |
| Imipenem | ≤0.125–4 | ≤0.125 | 0.25 | 0 | |
| Meropenem | ≤0.125–0.25 | ≤0.125 | ≤0.125 | 0 | |
| Vancomycin | ≤0.125–2 | 0.5 | 2 | NA | |
| Clindamycin | ≤0.5–16 | ≤0.5 | 2 | 3.2 | |
| Metronidazole | 1–16 | 1 | 2 | 0 | |
| Propionibacteriume spp. (9) | Ceftolozane | ≤0.125–16 | 0.5 | NA | |
| Ceftolozane-tazobactam | All ≤0.125 | ≤0.125 | NA | ||
| Ampicillin-sulbactam | All ≤0.5 | ≤0.5 | 0 | ||
| Piperacillin-tazobactam | All ≤0.5 | ≤0.5 | 0 | ||
| Moxifloxacin | All 1 | 1 | 0 | ||
| Linezolid | All 1 | 1 | 0 | ||
| Tigecycline | ≤0.06–0.5 | ≤0.06 | 0 | ||
| Imipenem | All ≤0.125 | ≤0.125 | 0 | ||
| Meropenem | ≤0.125–0.25 | ≤0.125 | 0 | ||
| Vancomycin | 0.25–1 | 0.5 | 0 | ||
| Clindamycin | ≤0.5–16 | ≤0.5 | 22.2 | ||
| Metronidazole | All >32 | >32 | 100 | ||
a
n, no. of isolates.
b
Percent resistance calculated using CLSI recommendations for most antimicrobial agents. For resistance breakpoints, refer to reference 9, CLSI document M11-A7. For tigecycline, the breakpoint for resistance of 16 μg/ml is the FDA recommendation. Please see reference 10, tigecycline package insert. NA, not applicable; there are no established breakpoints for these agents.
c
Includes isolates of the following Bacteroides species: 2 of Bacteroides dorei, 4 of Parabacteroides goldsteinii, 2 of Bacteroides intestinalis, 1 of Parabacteroides johnsonii, 1 of Parabacteroides merdae, 1 of Bacteroides stercoris, and 1 not identified to the species level.
d
Includes isolates of the following species: 3 of C. septicum, 1 of C. subterminale, 1 of C. tertium, 1 of C. cadaveris, 1 of C. clostridioforme, and 6 of Clostridium spp.
e
The number of Propionibacterium species isolates is less than 10; therefore, the MIC90 was not calculated.