Table 6.
In vitro activity of ceftazidime-avibactam and comparator agents against β-lactamase-positive P. aeruginosa isolates collected in the Latin American region as part of the ATLAS global surveillance program from 2017 to 2019.
| Antimicrobial agent | MIC (µg/ml) |
Interpretation (CLSI) |
||||
|---|---|---|---|---|---|---|
| Organism, phenotype/genotype (no. of isolates) | MIC50 | MIC90 | % Susceptible | % Intermediate | % Resistant | |
| ESBL-positive (50)a | Ceftazidime-avibactam | 32 | 128 | 34.0 | NA | 66.0 |
| Ceftazidime | >128 | >128 | 0 | 0 | 100 | |
| Cefepime | >16 | >16 | 0 | 4.0 | 96.0 | |
| Piperacillin-tazobactam | >64 | >64 | 8.0 | 34.0 | 58.0 | |
| Meropenem | >8 | >8 | 0 | 16.0 | 84.0 | |
| Levofloxacin | >8 | >8 | 0 | 0 | 100 | |
| Amikacin | >32 | >32 | 14.0 | 4.0 | 82.0 | |
| Colistin | 1 | 2 | NA | 98.0 | 2.0 | |
| KPC-positive (51)b | Ceftazidime-avibactam | 8 | 32 | 64.7 | NA | 35.3 |
| Ceftazidime | 128 | >128 | 2.0 | 3.9 | 94.1 | |
| Cefepime | >16 | >16 | 0 | 0 | 100 | |
| Piperacillin-tazobactam | >64 | >64 | 0 | 0 | 100 | |
| Meropenem | >8 | >8 | 0 | 0 | 100 | |
| Levofloxacin | >8 | >8 | 11.8 | 2.0 | 86.3 | |
| Amikacin | 16 | >32 | 52.9 | 13.7 | 33.3 | |
| Colistin | 1 | 1 | NA | 100 | 0 | |
| GES-type carbapenemase-positive (29)c | Ceftazidime-avibactam | 64 | 64 | 10.3 | NA | 89.7 |
| Ceftazidime | >128 | >128 | 3.4 | 3.4 | 93.1 | |
| Cefepime | >16 | >16 | 6.9 | 0 | 93.1 | |
| Piperacillin-tazobactam | >64 | >64 | 3.4 | 6.9 | 89.7 | |
| Meropenem | >8 | >8 | 0 | 0 | 100 | |
| Levofloxacin | >8 | >8 | 3.4 | 0 | 96.6 | |
| Amikacin | >32 | >32 | 3.4 | 0 | 96.6 | |
| Colistin | 1 | 1 | NA | 100 | 0 | |
| MBL-positive (214)d | Ceftazidime-avibactam | 32 | >128 | 4.2 | NA | 95.8 |
| Ceftazidime | 64 | >128 | 1.4 | 6.5 | 92.1 | |
| Cefepime | >16 | >16 | 4.2 | 27.1 | 68.7 | |
| Piperacillin-tazobactam | 64 | >64 | 4.7 | 54.7 | 40.7 | |
| Meropenem | >8 | >8 | 0 | 2.3 | 97.7 | |
| Levofloxacin | >8 | >8 | 3.7 | 1.9 | 94.4 | |
| Amikacin | >32 | >32 | 14.0 | 8.4 | 77.6 | |
| Colistin | 1 | 2 | NA | 100 | 0 | |
| No acquired β-lactamase (479) | Ceftazidime-avibactam | 4 | 8 | 92.5 | NA | 7.5 |
| Ceftazidime | 8 | 64 | 59.9 | 8.1 | 31.9 | |
| Cefepime | 8 | >16 | 54.5 | 21.9 | 23.6 | |
| Piperacillin-tazobactam | 32 | >64 | 46.8 | 21.1 | 32.2 | |
| Meropenem | 8 | >8 | 0 | 28.2 | 71.8 | |
| Levofloxacin | 2 | >8 | 35.3 | 16.5 | 48.2 | |
| Amikacin | 4 | >32 | 77.2 | 3.8 | 19.0 | |
| Colistin | 1 | 2 | NA | 99.8 | 0.2 | |
ESBL-positive, isolates in which one or more β-lactamase genes encoding a PER-type or GES-type ESBL was detected by PCR; does not include isolates that co-carry serine carbapenemases or MBLs.
KPC-positive, isolates in which a gene encoding a KPC carbapenemase was detected by PCR; includes isolates that co-carry original (narrow) spectrum β-lactamases but does not include isolates that co-carry ESBLs or MBLs.
GES-type carbapenemase-positive, isolates in which a gene encoding GES-20 was detected by PCR; includes isolates that co-carry GES-type ESBLs (GES-1, GES-19, GES-26) but does not include isolates that co-carry other serine β-lactamases or MBLs.
MBL-positive, isolates in which a gene encoding an NDM-type, IMP-type, VIM-type or SPM-type MBL was detected by PCR; includes isolates that co-carry serine β-lactamases (original (narrow) spectrum β-lactamases, PER-type or GES-type ESBLs, KPC or GES-type carbapenemases) and five isolates co-carrying two MBLs (IMP-18 and VIM-2).