Increased zinc levels facilitate phenotypic detection of ceftazidime-avibactam resistance in metallo-β-lactamase-producing Gram-negative bacteria

Simon M, Gerlach R, Pfeifer Y, Pfennigwerth N, Gatermann SG, Schröder A, Hiergeist A, Hamprecht A, Rügamer T, Gessner A, Jantsch J (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Frontiers in Microbiology Frontiers Media

Book Volume: 13

Article Number: 977330

DOI: 10.3389/fmicb.2022.977330

Abstract

Ceftazidime-avibactam is one of the last resort antimicrobial agents for the treatment of carbapenem-resistant, Gram-negative bacteria. Metallo-β-lactamase-producing bacteria are considered to be ceftazidime-avibactam resistant. Here, we evaluated a semi-automated antimicrobial susceptibility testing system regarding its capability to detect phenotypic ceftazidime-avibactam resistance in 176 carbapenem-resistant, metallo-β-lactamase-producing Enterobacterales and Pseudomonas aeruginosa isolates. Nine clinical isolates displayed ceftazidime-avibactam susceptibility in the semi-automated system and six of these isolates were susceptible by broth microdilution, too. In all nine isolates, metallo-β-lactamase-mediated hydrolytic activity was demonstrated with the EDTA-modified carbapenemase inactivation method. As zinc is known to be an important co-factor for metallo-β-lactamase activity, test media of the semi-automated antimicrobial susceptibility testing system and broth microdilution were supplemented with zinc. Thereby, the detection of phenotypic resistance was improved in the semi-automated system and in broth microdilution. Currently, ceftazidime-avibactam is not approved as treatment option for infections by metallo-β-lactamase-producing, Gram-negative bacteria. In infections caused by carbapenem-resistant Gram-negatives, we therefore recommend to rule out the presence of metallo-β-lactamases with additional methods before initiating ceftazidime-avibactam treatment.

Authors with CRIS profile

Roman Gerlach Institute of Microbiology – Clinical Microbiology, Immunology and Hygiene

Involved external institutions

Universitätsklinikum Regensburg DE Germany (DE) Robert Koch-Institut (RKI) DE Germany (DE) Ruhr-Universität Bochum (RUB) DE Germany (DE) Universitätsklinikum Köln DE Germany (DE)

How to cite

APA:

Simon, M., Gerlach, R., Pfeifer, Y., Pfennigwerth, N., Gatermann, S.G., Schröder, A.,... Jantsch, J. (2022). Increased zinc levels facilitate phenotypic detection of ceftazidime-avibactam resistance in metallo-β-lactamase-producing Gram-negative bacteria. Frontiers in Microbiology, 13. https://doi.org/10.3389/fmicb.2022.977330

MLA:

Simon, Michaela, et al. "Increased zinc levels facilitate phenotypic detection of ceftazidime-avibactam resistance in metallo-β-lactamase-producing Gram-negative bacteria." Frontiers in Microbiology 13 (2022).

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