High Rates of Nonsusceptibility to Ceftazidime-avibactam and Identification of New Delhi Metallo-β-lactamase Production in Enterobacteriaceae Bloodstream Infections at a Major Cancer Center

Samuel L Aitken; Jeffrey J Tarrand; Lalitagauri M Deshpande; Frank P Tverdek; Anne L Jones; Samuel A Shelburne; Randall A Prince; Micah M Bhatti; Kenneth V I Rolston; Ronald N Jones; Mariana Castanheira; Roy F Chemaly

doi:10.1093/cid/ciw398

High Rates of Nonsusceptibility to Ceftazidime-avibactam and Identification of New Delhi Metallo-β-lactamase Production in Enterobacteriaceae Bloodstream Infections at a Major Cancer Center

Clin Infect Dis. 2016 Oct 1;63(7):954-958. doi: 10.1093/cid/ciw398. Epub 2016 Jun 16.

Authors

Affiliations

¹ Division of Pharmacy.
² Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Texas.
³ Department of Laboratory Medicine.
⁴ JMI Laboratories, North Liberty, Iowa.
⁵ Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center.

PMID: 27313265
DOI: 10.1093/cid/ciw398

Abstract

Resistance to the novel β-lactam/β-lactamase inhibitor combination ceftazidime-avibactam (CAZ-AVI) among carbapenem-resistant Enterobacteriaceae (CRE) has infrequently been reported in the United States. We report unexpectedly high rates of resistance to CAZ-AVI in CRE bloodstream isolates at our institution associated with the nonoutbreak spread of New Delhi metallo-β-lactamase in diverse Enterobacteriaceae species.

Keywords: CRE; NDM; bacteremia; carbapenemase; ceftazidime-avibactam.

MeSH terms

Adult
Aged
Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use*
Azabicyclo Compounds / pharmacology
Azabicyclo Compounds / therapeutic use*
Bacteremia* / drug therapy
Bacteremia* / epidemiology
Bacteremia* / microbiology
Cancer Care Facilities
Ceftazidime / pharmacology
Ceftazidime / therapeutic use*
Child, Preschool
Drug Combinations
Drug Resistance, Bacterial
Enterobacteriaceae Infections* / drug therapy
Enterobacteriaceae Infections* / epidemiology
Enterobacteriaceae Infections* / microbiology
Enterobacteriaceae* / drug effects
Enterobacteriaceae* / enzymology
Enterobacteriaceae* / genetics
Female
Humans
Male
Middle Aged
Young Adult
beta-Lactamases

Substances

Anti-Bacterial Agents
Azabicyclo Compounds
Drug Combinations
avibactam, ceftazidime drug combination
Ceftazidime
beta-Lactamases
beta-lactamase NDM-1