Ceftazidime-avibactam resistance determination in carbapenem-resistant Klebsiella pneumoniae infections before its use in practice

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dc.contributor.authorEren-Kutsoylu, Oya Ozlem
dc.contributor.authorCeylan-Cimendag, Hacer
dc.contributor.authorSari-Kaygisiz, Ayse Nur
dc.contributor.authorTanriverdi, Elif Seren
dc.contributor.authorOzbek, Ozgen Alpay
dc.contributor.authorOktem, Ibrahim Mehmet Ali
dc.contributor.authorOtlu, Baris
dc.date.accessioned2026-04-04T13:30:53Z
dc.date.available2026-04-04T13:30:53Z
dc.date.issued2024
dc.departmentİnönü Üniversitesi
dc.description.abstractIntroduction: To ensure the appropriate usage of ceftazidime-avibactam (CAZ-AVI), recently introduced in our hospital, we aimed to determine susceptibility rates, enzyme analysis, and clonal relationship among strains, together with clinical data. Methodology: Between June 1 and September 30, 2021, demographic and microbiological data of the patients were recorded. In the obtained samples, meropenem and colistin minimal inhibitory concentration (MIC) levels, carbapenem resistance genes, and the clonal relationship were studied by molecular methods. CAZ-AVI was not used in any of the patients. Results: 140 carbapenem-resistant Klebsiella pneumoniae were isolated from 57 patients. Resistance to CAZ-AVI was found in 76 (54.3%) strains. Out of 57 patients, 31 (54.4%) isolates could be reached. Meropenem MIC level was >= 32 mu g/mL in 26 (83.9%), and colistin MIC level was >= 4 mu g/mL in 17 (54.8%) isolates. Enzyme analysis revealed NDM in 20 (64.5%), OXA-48 in 17 (54.8%), and KPC in seven (22.6%). NDM + OXA-48 was determined in 10 (32.2%) strains. NDM was determined in all CAZ-AVI resistant strains, OXA-48 in 16.1% (2/5) strains. Seven genotypes were detected. The largest cluster was genotype 3 clusters (11 isolates). Of 31 patients, 22 (71.0%) died. CAZ-AVI was susceptible in one of the patients who survived and four who died. Conclusion: Before using a new antibiotic, each center should determine the basal data and phenotypic/genotypic resistance ratios specific to that antibiotic. While a high NDM rate and low CAZ-AVI sensitivity limit the use of the drug in our center, it is clear that CAZ-AVI use in sensitive strains will decrease mortality.
dc.identifier.doi10.3855/jidc.18371
dc.identifier.endpage1025
dc.identifier.issn1972-2680
dc.identifier.issue7
dc.identifier.orcid0000-0001-7648-7730
dc.identifier.orcid0000-0003-3814-0474
dc.identifier.orcid0000-0002-6220-0521
dc.identifier.orcid0000-0002-0449-0356
dc.identifier.orcid0000-0002-3185-8355
dc.identifier.pmid39078779
dc.identifier.scopus2-s2.0-85200192274
dc.identifier.scopusqualityQ3
dc.identifier.startpage1020
dc.identifier.urihttps://doi.org/10.3855/jidc.18371
dc.identifier.urihttps://hdl.handle.net/11616/108445
dc.identifier.volume18
dc.identifier.wosWOS:001284715300006
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherJ Infection Developing Countries
dc.relation.ispartofJournal of Infection in Developing Countries
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectCeftazidime-avibactam
dc.subjectcarbapenem resistance
dc.subjectKlebsiella pneumoniae
dc.subjectNDM
dc.subjectAP-PCR.
dc.titleCeftazidime-avibactam resistance determination in carbapenem-resistant Klebsiella pneumoniae infections before its use in practice
dc.typeArticle

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