Sibylle H Lob1, Daryl J Hoban2, Katherine Young3, Mary R Motyl3, Daniel F Sahm2. 1. International Health Management Associates, Inc., 2122 Palmer Drive, Schaumburg, IL 60173, USA. Electronic address: shlob@ihma.com. 2. International Health Management Associates, Inc., 2122 Palmer Drive, Schaumburg, IL 60173, USA. 3. Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, NJ 07033, USA.
Abstract
OBJECTIVES: Antimicrobial resistance is increasing worldwide and is especially problematic in ICUs. Relebactam is a new bicyclic diazabicyclooctane β-lactamase inhibitor of class A and C β-lactamases that is in development in combination with imipenem. This study describes geographical resistance patterns among isolates from ICU and non-ICU wards in seven global regions and examines the activity of imipenem/relebactam in these settings. METHODS: In 2015-2016, 194 hospitals from 55 countries each collected up to 100 consecutive Gram-negative pathogens from intra-abdominal, 100 from lower respiratory and 50 from urinary tract infections per year. Susceptibility was determined for 45699 non-Proteeae Enterobacteriaceae (NPE) and 10834 Pseudomonas aeruginosa using CLSI broth microdilution and breakpoints, with imipenem breakpoints applied to imipenem/relebactam. RESULTS: Isolates from ICUs were more resistant to almost all tested agents across regions and infection sources. The size of the ICU/non-ICU difference varied, with a smaller gap in USA/Canada and South Pacific (regions with highest susceptibility) and for imipenem/relebactam, amikacin and colistin (drugs with highest activity). Susceptibility of NPE to imipenem/relebactam was >90% in ICUs in all regions except Africa (88.2%). Only amikacin exceeded these rates in most regions. Against cefepime-non-susceptible and multidrug-resistant (MDR) NPE from ICUs, imipenem/relebactam maintained activity >90% in three regions and >80% in the remaining regions except Africa (75%). Susceptibility of P. aeruginosa was >90% in ICUs in USA/Canada, South Pacific and Europe and >82% elsewhere. CONCLUSIONS: Imipenem/relebactam could provide a valuable therapeutic option in ICUs, especially against MDR isolates and those non-susceptible to other β-lactam antibiotics.
OBJECTIVES: Antimicrobial resistance is increasing worldwide and is especially problematic in ICUs. Relebactam is a new bicyclic diazabicyclooctane β-lactamase inhibitor of class A and C β-lactamases that is in development in combination with imipenem. This study describes geographical resistance patterns among isolates from ICU and non-ICU wards in seven global regions and examines the activity of imipenem/relebactam in these settings. METHODS: In 2015-2016, 194 hospitals from 55 countries each collected up to 100 consecutive Gram-negative pathogens from intra-abdominal, 100 from lower respiratory and 50 from urinary tract infections per year. Susceptibility was determined for 45699 non-Proteeae Enterobacteriaceae (NPE) and 10834 Pseudomonas aeruginosa using CLSI broth microdilution and breakpoints, with imipenem breakpoints applied to imipenem/relebactam. RESULTS: Isolates from ICUs were more resistant to almost all tested agents across regions and infection sources. The size of the ICU/non-ICU difference varied, with a smaller gap in USA/Canada and South Pacific (regions with highest susceptibility) and for imipenem/relebactam, amikacin and colistin (drugs with highest activity). Susceptibility of NPE to imipenem/relebactam was >90% in ICUs in all regions except Africa (88.2%). Only amikacin exceeded these rates in most regions. Against cefepime-non-susceptible and multidrug-resistant (MDR) NPE from ICUs, imipenem/relebactam maintained activity >90% in three regions and >80% in the remaining regions except Africa (75%). Susceptibility of P. aeruginosa was >90% in ICUs in USA/Canada, South Pacific and Europe and >82% elsewhere. CONCLUSIONS:Imipenem/relebactam could provide a valuable therapeutic option in ICUs, especially against MDR isolates and those non-susceptible to other β-lactam antibiotics.
Authors: James A Karlowsky; Sibylle H Lob; C Andrew DeRyke; David W Hilbert; Michael T Wong; Katherine Young; Fakhar Siddiqui; Mary R Motyl; Daniel F Sahm Journal: Antimicrob Agents Chemother Date: 2022-05-02 Impact factor: 5.938
Authors: Keith S Kaye; Helen W Boucher; Michelle L Brown; Angela Aggrey; Ireen Khan; Hee-Koung Joeng; Robert W Tipping; Jiejun Du; Katherine Young; Joan R Butterton; Amanda Paschke Journal: Antimicrob Agents Chemother Date: 2020-04-21 Impact factor: 5.191
Authors: James A Karlowsky; Samuel K Bouchillon; Ramy El Mahdy Kotb; Naglaa Mohamed; Gregory G Stone; Daniel F Sahm Journal: JAC Antimicrob Resist Date: 2022-06-17
Authors: Sibylle H Lob; Daryl D DePestel; C Andrew DeRyke; Krystyna M Kazmierczak; Katherine Young; Mary R Motyl; Daniel F Sahm Journal: Open Forum Infect Dis Date: 2021-06-16 Impact factor: 3.835