Evaluating the susceptibility to ceftazidime-avibactam in clinical isolates of Klebsiella pneumoniae and Pseudomonas aeruginosa recovered from an apex medical hospital in north India

Nargis  Bali; Nargis  Bali; Biswajyoti  Borkakoty; Roseleen  Bali; Anjum Ara  Mir; Zubair  Teli; Qounser  Nisar; Tantray  Faisal

doi:10.18502/ijm.v17i2.18385

Nargis Bali Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, India
Nargis Bali Department of Microbiology, Govt Medical College, Anantnag, Jammu & Kashmir, India
Biswajyoti Borkakoty Viral Research and Diagnostic Laboratory, Regional ICMR Laboratory, Dibrugarh Assam, India
Roseleen Bali Department of Respiratory and Pulmonary Medicine Apollo Hospital, New Delhi, India
Anjum Ara Mir Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, India
Zubair Teli Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, India
Qounser Nisar Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, India
Tantray Faisal Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu & Kashmir, India

DOI: https://doi.org/10.18502/ijm.v17i2.18385

Keywords: Antimicrobial drug resistance; Carbapenem antibiotics; Disc diffusion method; Intensive care unit

Abstract

Background and Objectives: We assessed the susceptibility of ceftazidime+avibactam (CZA/AVI) in Klebsiella pneumoni- ae and Pseudomonas aeruginosa isolated from intensive care units of our hospital.

Materials and Methods: Clinical samples from Jan 2022 to Dec 2023 at SKIMS Soura, were processed for the recovery of K. pneumoniae and P. aeruginosa. Susceptibility testing was done by disc diffusion (DD) method and minimum inhibitory concentration (MIC) for CZA/AVI and meropenem was assessed using E-test strips. Categorical agreement (CA), very major errors (VME), major errors (ME) and minor errors (mE) between DD and MIC were measured. Statistical analyses were performed using SPSS version 22.0.

Results: A total of 111 K. pneumoniae and 81 P. aeruginosa were part of the study. Of these, 56.8% K. pneumoniae and 45.7% P. aeruginosa isolates were susceptible to CZA/AVI. MIC of CZA/AVI for K. pneumoniae ranged from 0.125 to ≥ 256 μg/ml and for P. aeruginosa it ranged from 0.032 to 128 μg/ml. CA was 97.29% between DD and E-Test for CZA/AVI in K. pneumoniae isolates, with a ME of 2.70%. For P. aeruginosa CA between DD and E-Test for CZA/AVI was 98.76% with a VME of 1.23%. MIC values of meropenem were higher than CZA/AVI even in sensitive isolates.

Conclusion: CZA/AVI shows good in-vitro activity against clinical isolates of K. pneumoniae and P. aeruginosa and can be part of empirical therapy for treating infections caused by these bacteria.