Activity of imipenem-relebactam, ceftolozane-tazobactam and comparators against clinical isolates of Enterobacterales and Pseudomonas aeruginosa causing severe infections in hematological and oncological patients: A prospective multicenter study
Abstract
OBJECTIVES: Studies regarding the activity of antimicrobials against isolates causing severe infections in oncological and hematological patients are scarce. Ceftolozane-tazobactam (TOL/TAZ) and imipenem-relebactam (IMP/REL) are among the new antimicrobials active against multiresistant gramnegative microorganisms. We evaluate the in vitro activity of these antimicrobials and comparators against recent clinical isolates from hematology and oncology patients in Spain.
METHODS: A total of 55 centers participated in a nationwide study. The isolates were prospectively recovered from patients with bacteremia, lower respiratory tract infections (LRTIs), complicated urinary infections (cUTI), and complicated intra-abdominal infections (cIAIs). The activities of TOL/TAZ, IMP/REL, imipenem (IMP), meropenem (MER), ceftazidime (CAZ), cefepime (FEP), piperacillin-tazobactam (PIP/TAZ), levofloxacin (LEV), and amikacin (AK) were studied following the EUCAST guidelines. Resistance mechanisms were detected by standard methods.
RESULTS: A total of 997 isolates (563 Enterobacterales (EB) and 434 Pseudomonas aeruginosa (PA)) were collected. The source of EB/PA were: bacteremia (n = 347/182), LRT (n = 51/139), urine (n = 95/64), and intraabdominal samples (n = 70/49). Among EB, 93.6%, 98.9%, 98.6%, 87.4%, 82.2%, 93.6%, 98.6%, 73.7%, and 97.3% were susceptible to TOL/TAZ, IMP/REL, MER, FEP, CAZ, PIP/TAZ, IMP, LEV, and AK, respectively. The corresponding values for PA were 92.2%, 90.1%, 87.8%,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 347 participants or records.
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