TABLE 1.
In vitro activities of antibiotics tested against Enterobacterales with blaNDM collected in the United States from January 2017 to November 2018
| Organism(s) (n) and druga | MIC (μg/ml) |
CLSI interpretive criteria |
||||
|---|---|---|---|---|---|---|
| Range | MIC50 | MIC90 | % Sb | % Ic | % Rd | |
| All Enterobacterales (275) | ||||||
| Doripenem | 1 to >8 | >8 | >8 | 0.4 | 2.9 | 96.7 |
| Imipenem | 2 to >64 | 16 | 64 | 0.0 | 2.9 | 97.1 |
| Meropenem | 0.5 to >8 | >8 | >8 | 1.8 | 1.8 | 96.4 |
| Cefepimee | 8 to >32 | >32 | >32 | 0.0 | 0.7 | 99.3 |
| Piperacillin-tazobactam | 16/4 to >128/4 | >128/4 | >128/4 | 0.7 | 0.7 | 98.5 |
| Aztreonam | <2 to >64 | >64 | >64 | 18.2 | 1.8 | 80.0 |
| Ceftazidime-avibactam | <0.5/4 to >16/4 | >16/4 | >16/4 | 0.7 | NAf | 99.3 |
| Imipenem-relebactam | 2/4 to >64/4 | 8/4 | 32/4 | 0.0 | 2.5 | 97.5 |
| Meropenem-vaborbactam | <0.5/8 to >16/8 | 16/8 | >16/8 | 10.2 | 17.1 | 72.7 |
| Aztreonam-avibactam | <0.03/4 to 32/4 | 0.25/4 | 4/4 | NA | NA | NA |
| Cefepime-taniborbactam | 0.12/4 to >64/4 | 2/4 | 32/4 | NA | NA | NA |
| Cefepime-zidebactam | 0.06/0.06 to >64/64 | 0.25/0.25 | 4/4 | NA | NA | NA |
| Ciprofloxacin | <0.25 to >8 | >8 | >8 | 5.8 | 2.5 | 91.6 |
| Levofloxacin | <0.12 to >8 | >8 | >8 | 9.8 | 4.4 | 85.8 |
| Amikacin | <1 to >64 | 16 | >64 | 52.7 | 0.7 | 46.5 |
| Gentamicin | <0.25 to >16 | >16 | >16 | 32.0 | 1.8 | 66.2 |
| Plazomicin | 0.12 to >128 | 2 | >128 | 52.7 | 1.5 | 45.8 |
| Tobramycin | <0.5 to >16 | >16 | >16 | 20.0 | 5.5 | 74.5 |
| Eravacycline | 0.12 to >4 | 0.5 | 2 | 66.2 | NA | NA |
| Minocycline | <4 to >16 | 8 | >16 | 48.4 | 16.4 | 35.3 |
| Omadacycline | 0.5 to >32 | 4 | 32 | 59.6 | 18.9 | 21.5 |
| Tetracycline | <2 to >32 | >32 | >32 | 35.6 | 6.9 | 57.5 |
| Tigecycline | <0.5 to >4 | <0.5 | 4 | 86.5 | 8.4 | 5.1 |
| Trimethoprim-sulfamethoxazole | <0.5/8.5 to >8/152 | >8/152 | >8/152 | 20.7 | NA | 79.3 |
| Chloramphenicol | <2 to >16 | >16 | >16 | 24.0 | 22.2 | 53.8 |
| Nitrofurantoing | <16 to >128 | 64 | >128 | 35.3 | 16.4 | 48.4 |
| Nitrofurantoinh (n = 144) | <16 to >128 | 64 | >128 | 45.1 | 12.5 | 42.4 |
| Colistin | <0.25 to >8 | 0.5 | 1 | NA | NA | NA |
| Escherichia coli (115) | ||||||
| Doripenem | 1 to >8 | >8 | >8 | 0.9 | 2.6 | 96.5 |
| Imipenem | 2 to 64 | 8 | 16 | 0.0 | 2.6 | 97.4 |
| Meropenem | 0.5 to >8 | >8 | >8 | 1.7 | 0.9 | 97.4 |
| Cefepime | 16 to >32 | >32 | >32 | 0.0 | 0.0 | 100.0 |
| Piperacillin-tazobactam | 128/4 to >128/4 | >128/4 | >128/4 | 0.0 | 0.0 | 100.0 |
| Aztreonam | <2 to >64 | >64 | >64 | 15.7 | 1.7 | 82.6 |
| Ceftazidime-avibactam | <0.5/4 to >16/4 | >16/4 | >16/4 | 0.9 | NA | 99.1 |
| Imipenem-relebactam | 2/4 to 64/4 | 8/4 | 16/4 | 0.0 | 1.7 | 98.3 |
| Meropenem-vaborbactam | <0.5/8 to >16/8 | >16/8 | >16/8 | 6.1 | 17.4 | 76.5 |
| Aztreonam-avibactam | <0.03/4 to 32/4 | 2/4 | 8/4 | NA | NA | NA |
| Cefepime-taniborbactam | 0.12/4 to >64/4 | 8/4 | 32/4 | NA | NA | NA |
| Cefepime-zidebactam | 0.06/0.06 to 4/4 | 0.12/0.12 | 0.5/0.5 | NA | NA | NA |
| Ciprofloxacin | <0.25 to >8 | >8 | >8 | 3.5 | 0.0 | 96.5 |
| Levofloxacin | <0.12 to >8 | >8 | >8 | 5.2 | 1.7 | 93.0 |
| Amikacin | <1 to >64 | 8 | >64 | 59.1 | 0.0 | 40.9 |
| Gentamicin | <0.25 to >16 | >16 | >16 | 39.1 | 1.7 | 59.1 |
| Plazomicin | 0.25 to >128 | 2 | >128 | 56.5 | 1.7 | 41.7 |
| Tobramycin | <0.5 to >16 | >16 | >16 | 32.2 | 2.6 | 65.2 |
| Eravacycline | 0.12 to 4 | 0.5 | 1 | 87.0 | NA | NA |
| Minocycline | <4 to >16 | <4 | >16 | 53.0 | 13.0 | 33.9 |
| Omadacycline | 0.5 to 32 | 2 | 8 | 86.1 | 9.6 | 4.3 |
| Tetracycline | <2 to >32 | >32 | >32 | 25.2 | 0.9 | 73.9 |
| Tigecycline | <0.5 to 2 | <0.5 | <0.5 | 100.0 | 0.0 | 0.0 |
| Trimethoprim-sulfamethoxazole | <0.5/8.5 to >8/152 | >8/152 | >8/152 | 15.7 | NA | 84.3 |
| Chloramphenicol | <2 to >16 | 16 | >16 | 32.4 | 34.3 | 39.1 |
| Nitrofurantoin | <16 to >128 | <16 | 128 | 77.4 | 11.3 | 11.3 |
| Nitrofurantoinh (n = 78) | <16 to >128 | <16 | 128 | 76.9 | 11.5 | 11.5 |
| Colistin | 0.5 to 4 | 0.5 | 1 | NA | NA | NA |
| Klebsiella pneumoniae (125) | ||||||
| Doripenem | 2 to >8 | >8 | >8 | 0.0 | 0.8 | 99.2 |
| Imipenem | 2 to >64 | 16 | 64 | 0.0 | 0.8 | 99.2 |
| Meropenem | 1 to >8 | >8 | >8 | 0.8 | 1.6 | 97.6 |
| Cefepime | 16 to >32 | >32 | >32 | 0.0 | 0.0 | 100.0 |
| Piperacillin-tazobactam | >128/4 | >128/4 | >128/4 | 0.0 | 0.0 | 100.0 |
| Aztreonam | <2 to >64 | >64 | >64 | 21.6 | 2.4 | 76.0 |
| Ceftazidime-avibactam | 2/4 to >16/4 | >16/4 | >16/4 | 0.8 | NA | 99.2 |
| Imipenem-relebactam | 2/4 to >64/4 | 16/4 | 64/4 | 0.0 | 2.4 | 97.6 |
| Meropenem-vaborbactam | 1/8 to >16/8 | 16/8 | >16/8 | 10.4 | 16.8 | 72.8 |
| Aztreonam-avibactam | <0.03/4 to 4/4 | 0.25/4 | 0.5/4 | NA | NA | NA |
| Cefepime-taniborbactam | 0.12/4 to >64/4 | 1/4 | 32/4 | NA | NA | NA |
| Cefepime-zidebactam | 0.06/0.06 to >64/64 | 0.5/0.5 | 4/4 | NA | NA | NA |
| Ciprofloxacin | <0.25 to >8 | >8 | >8 | 5.6 | 0.0 | 94.4 |
| Levofloxacin | <0.12 to >8 | >8 | >8 | 8.0 | 5.6 | 86.4 |
| Amikacin | <1 to >64 | >64 | >64 | 40.8 | 0.8 | 58.4 |
| Gentamicin | <0.25 to >16 | >16 | >16 | 24.0 | 2.4 | 73.6 |
| Plazomicin | 0.12 to >128 | >128 | >128 | 43.2 | 0.8 | 56.0 |
| Tobramycin | <0.5 to >16 | >16 | >16 | 8.0 | 4.8 | 87.2 |
| Eravacycline | 0.25 to >4 | 0.5 | 4 | 51.2 | NA | NA |
| Minocycline | <4 to >16 | 8 | >16 | 44.8 | 21.6 | 33.6 |
| Omadacycline | 1 to >32 | 8 | 32 | 39.2 | 28.0 | 32.8 |
| Tetracycline | <2 to >32 | 8 | >32 | 44.8 | 13.6 | 41.6 |
| Tigecycline | <0.5 to >4 | 1 | 4 | 79.2 | 14.4 | 6.4 |
| Trimethoprim-sulfamethoxazole | <0.5/8.5 to >8/152 | >8/152 | >8/152 | 24.0 | NA | 76.0 |
| Chloramphenicol | <2 to >16 | >16 | >16 | 19.2 | 16.8 | 64.0 |
| Nitrofurantoin | <16 to >128 | >128 | >128 | 4.0 | 16.8 | 79.2 |
| Nitrofurantoinh (n = 51) | <16 to >128 | >128 | >128 | 3.9 | 11.8 | 84.3 |
| Colistin | <0.25 to >8 | 0.5 | 1 | NA | NA | NA |
a
Categorical interpretation was determined according to CLSI document M100-S29 when available (14). Imipenem-relebactam, plazomicin, eravacycline, omadacycline, and tigecycline categorical interpretation was determined by FDA interpretive criteria (15).
b
S, susceptible.
c
I, intermediate.
d
R, resistant.
e
Cefepime does not have an intermediate category but has a susceptible-dose-dependent category (14).
f
NA, not applicable (no breakpoint available for this category or drug).
g
Categorical interpretation applies only to organisms from urine (14).
h
Reported for isolates originating from urine cultures.