Antimicrobial activity of plazomicin against Enterobacteriaceae producing carbapenemases from 50 Brazilian medical centers

Publication date: Available online 10 November 2017
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Andreza Faria Martins, Larissa Bail, Carmen Antonia Sanches Ito, Keite da Silva Nogueira, Tanise Vendruscolo Dalmolin, Amanda Silva Martins, Jaime Luis Lopes Rocha, Alisa W. Serio, Felipe Francisco Tuon
BackgroundPlazomicin is a next-generation aminoglycoside with activity against Enterobacteriaceae, including carbapenemase-producing Enterobacteriaceae (CPE).ObjectiveThe aim of this study was to evaluate the activity of plazomicin against CPE (Klebsiella spp., E. coli, Serratia spp., Enterobacter spp., Citrobacter spp., Morganella spp., Proteus spp., Providencia spp.) from different Brazilian hospitals.MethodsA total of 4000 carbapenem-resistant Enterobacteriaceae isolates were collected from clinical samples in 50 Brazilian hospitals during 2013–2015. Of these, 499 carbapenem-resistant isolates (CLSI criteria) were selected for further evaluation via broth microdilution to assess for the activity of plazomicin, colistin, tigecycline, meropenem, amikacin and gentamicin. Additionally, the isolates were assessed for the presence of carbapenemase genes (blaKPC, blaNDM, blaOXA-48-like, blaIMP, blaBKC, blaGES and blaVIM) by polymerase chain reaction (PCR). When PCR was positive to blaOXA-48-like, blaIMP, blaGES and blaVIM, the carbapenemase genes were sequenced.ResultsblaKPC was the most prevalent carbapenemase gene found (n=397), followed by blaNDM (n=81), blaOXA-48 (n=12) and blaIMP-1 (n=3). Other genes were identified in only one isolate each: blaBKC-1, blaGES-16, blaGES-1, blaOXA-370, blaVIM-1. One isolate had two carbapenemase genes (blaKPC and blaNDM). 33% of the isolates were non-susceptible to colistin, 24% to tigecycline, 97% to meropenem, 50% to amikacin and 82% to gentamicin (via EUCAST criteria). The plazomicin MIC50/90 was 0.5/ ≥ 64mg/L, with 84% of MICs ≤2mg/L and 87% of MICs ≤4mg/L. Elevated MICs to plazomicin were not associated with a specific carbapenemase or bacterial species.ConclusionThe MICs of plazomicin against CPE were lower than that of other aminoglycosides. Plazomicin is a promising drug for the treatment of CPE infections.



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