BACKGROUND: Imipenem/relebactam is a novel carbapenem/β-lactamase inhibitor combination, developed to act against carbapenemase-producing Enterobacterales (CPE). OBJECTIVES: To assess the in vitro activity of imipenem/relebactam against a Spanish nationwide collection of CPE by testing the susceptibility of these isolates to 16 widely used antimicrobials and to determine the underlying β-lactam resistance mechanisms involved and the molecular epidemiology of carbapenemases in Spain. MATERIALS AND METHODS: Clinical CPE isolates (n = 401) collected for 2 months from 24 hospitals in Spain were tested. MIC50, MIC90 and susceptibility/resistance rates were interpreted in accordance with the EUCAST guidelines. β-Lactam resistance mechanisms and molecular epidemiology were characterized by WGS. RESULTS: For all isolates, high rates of susceptibility to colistin (86.5%; MIC50/90 = 0.12/8 mg/L), imipenem/relebactam (85.8%; MIC50/90 = 0.5/4 mg/L) and ceftazidime/avibactam (83.8%, MIC50/90 = 1/≥256 mg/L) were observed. The subgroups of isolates producing OXA-48-like (n = 305, 75.1%) and KPC-like enzymes (n = 44, 10.8%) were highly susceptible to ceftazidime/avibactam (97.7%, MIC50/90 = 1/2 mg/L) and imipenem/relebactam (100.0%, MIC50/90 = ≤0.25/1 mg/L), respectively.The most widely disseminated high-risk clones of carbapenemase-producing Klebsiella pneumoniae across Spain were found to be ST11, ST147, ST392 and ST15 (mostly associated with OXA-48) and ST258/512 (in all cases producing KPC). CONCLUSIONS: Imipenem/relebactam, colistin and ceftazidime/avibactam were the most active antimicrobials against all CPEs. Imipenem/relebactam is a valuable addition to the antimicrobial arsenal used in the fight against CPE, particularly against KPC-producing isolates, which in all cases were susceptible to this combination.
BACKGROUND:Imipenem/relebactam is a novel carbapenem/β-lactamase inhibitor combination, developed to act against carbapenemase-producing Enterobacterales (CPE). OBJECTIVES: To assess the in vitro activity of imipenem/relebactam against a Spanish nationwide collection of CPE by testing the susceptibility of these isolates to 16 widely used antimicrobials and to determine the underlying β-lactam resistance mechanisms involved and the molecular epidemiology of carbapenemases in Spain. MATERIALS AND METHODS: Clinical CPE isolates (n = 401) collected for 2 months from 24 hospitals in Spain were tested. MIC50, MIC90 and susceptibility/resistance rates were interpreted in accordance with the EUCAST guidelines. β-Lactam resistance mechanisms and molecular epidemiology were characterized by WGS. RESULTS: For all isolates, high rates of susceptibility to colistin (86.5%; MIC50/90 = 0.12/8 mg/L), imipenem/relebactam (85.8%; MIC50/90 = 0.5/4 mg/L) and ceftazidime/avibactam (83.8%, MIC50/90 = 1/≥256 mg/L) were observed. The subgroups of isolates producing OXA-48-like (n = 305, 75.1%) and KPC-like enzymes (n = 44, 10.8%) were highly susceptible to ceftazidime/avibactam (97.7%, MIC50/90 = 1/2 mg/L) and imipenem/relebactam (100.0%, MIC50/90 = ≤0.25/1 mg/L), respectively.The most widely disseminated high-risk clones of carbapenemase-producing Klebsiella pneumoniae across Spain were found to be ST11, ST147, ST392 and ST15 (mostly associated with OXA-48) and ST258/512 (in all cases producing KPC). CONCLUSIONS:Imipenem/relebactam, colistin and ceftazidime/avibactam were the most active antimicrobials against all CPEs. Imipenem/relebactam is a valuable addition to the antimicrobial arsenal used in the fight against CPE, particularly against KPC-producing isolates, which in all cases were susceptible to this combination.
Authors: Javier E Cañada-García; Zaira Moure; Pedro J Sola-Campoy; Mercedes Delgado-Valverde; María E Cano; Desirèe Gijón; Mónica González; Irene Gracia-Ahufinger; Nieves Larrosa; Xavier Mulet; Cristina Pitart; Alba Rivera; Germán Bou; Jorge Calvo; Rafael Cantón; Juan José González-López; Luis Martínez-Martínez; Ferran Navarro; Antonio Oliver; Zaira R Palacios-Baena; Álvaro Pascual; Guillermo Ruiz-Carrascoso; Jordi Vila; Belén Aracil; María Pérez-Vázquez; Jesús Oteo-Iglesias Journal: Front Microbiol Date: 2022-06-30 Impact factor: 6.064
Authors: Juan Carlos Vázquez-Ucha; Cristina Lasarte-Monterrubio; Paula Guijarro-Sánchez; German Bou; Alejandro Beceiro; Marina Oviaño; Laura Álvarez-Fraga; Isaac Alonso-García; Jorge Arca-Suárez Journal: Antimicrob Agents Chemother Date: 2021-11-22 Impact factor: 5.938
Authors: Eva Gato; Ignacio Pedro Constanso; Ana Candela; Fátima Galán; Bruno Kotska Rodiño-Janeiro; Manuel Jesús Arroyo; Gema Méndez; Luis Mancera; Tyler Alioto; Marta Gut; Ivo Gut; Miguel Álvarez-Tejado; Belén Rodríguez-Sánchez; Germán Bou; Marina Oviaño Journal: J Clin Microbiol Date: 2021-06-18 Impact factor: 5.948