P-1083. Antimicrobial Activity of Aztreonam-Avibactam and Comparator Agents against a Large Collection of Stenotrophomonas maltophilia Isolates Collected in United States Medical Centers (2019-2023)
Abstract
Abstract Background The occurrence of S. maltophilia infections has increased continuously in the last few years. We evaluated the in vitro activities of aztreonam-avibactam (ATM-AVI) and comparators against a large collection of S. maltophilia clinical isolates. Activity of aztreonam-avibactam and comparator agents stratified by infection type. Methods 1,400 clinical isolates were consecutively collected from 62 United States (US) medical centers. Infection sites included pneumonia (n=1,020), bacteremia (n=117), skin and skin-structure infection (SSSI; n=124), and others (n=139). Isolates were susceptibility tested by CLSI M07 broth microdilution methods. ATM-AVI was tested with AVI at fixed 4 mg/L and a pharmacodynamic/pharmacokinetic susceptible (S) breakpoint of ≤ 8 mg/L was applied for comparison. Results ATM-AVI inhibited 99.6% of isolates at ≤ 8 mg/L (MIC50/90, 2/4 mg/L) and demonstrated potent activity against isolates from all infection types (Table). ATM-AVI inhibited 99.7% of isolates from pneumonia and 100.0% of isolates from BSI at ≤ 8 mg/L and retained potent activity against isolates non-S to other agents commonly used to treat S. maltophilia infections. ATM-AVI was active (MIC ≤ 8 mg/L) against 100.0% of trimethoprim-sulfamethoxazole (TMP-SMX)-non-S isolates, 99.3% of isolates non-S to minocycline or levofloxacin, and 99.5% of isolates with tigecycline MIC > 2 mg/L. Moreover, ATM-AVI activity remained stable during the study period; the percentages inhibited…
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