In vitro activity of ceftazidime–avibactam and comparators against Gram-negative bacterial isolates collected in the Asia–Pacific region as part of the INFORM program (2015–2017)

Ko, Wen-Chien; Stone, Gregory G.

doi:10.1186/s12941-020-00355-1

Annals of Clinical Microbiology and Antimicrobials

Table 2 In vitro antimicrobial activity of ceftazidime–avibactam and comparators against Enterobacterales, Escherichia coli, and Klebsiella pneumoniae isolates collected in the Asia–Pacific region (INFORM program, 2015–2017)

From: In vitro activity of ceftazidime–avibactam and comparators against Gram-negative bacterial isolates collected in the Asia–Pacific region as part of the INFORM program (2015–2017)

Organism/antimicrobial	MIC₅₀ (mg/L)	MIC₉₀ (mg/L)	MIC range (mg/L)	% S	% R
Enterobacterales (N = 7051)^a
Amikacin	2	4	≤ 0.25–≥ 64	96.8	1.6
Amoxicillin–clavulanic acid	8	≥ 64	≤ 0.12–≥ 64	51.3	48.7
Aztreonam	0.12	64	≤ 0.015–≥ 256	69.4	26.6
Cefepime	≤ 0.12	≥ 32	≤ 0.12–≥ 32	75.5	20.3
Ceftazidime	0.25	64	≤ 0.015–≥ 256	69.0	26.7
Ceftazidime–avibactam	0.12	0.5	≤ 0.015–≥ 256	98.1	1.9
Colistin	0.25	≥ 16	≤ 0.06–≥ 16	83.9	16.1
Imipenem	0.25	2	≤ 0.03–≥ 16	85.3	2.3
Levofloxacin	0.12	≥ 16	≤ 0.004–≥ 16	66.2	27.8
Meropenem	0.03	0.12	≤ 0.004–≥ 16	97.7	1.6
Piperacillin–tazobactam	2	64	≤ 0.25–≥ 256	82.5	13.4
Tigecycline^b	0.5	1	≤ 0.015–≥ 16	N/A	N/A
Enterobacterales, ESBL-positive, carbapenemase-negative (N = 1259)
Amikacin	2	8	≤ 0.25–≥ 64	91.0	3.7
Amoxicillin–clavulanic acid	16	32	1–≥ 64	26.7	73.3
Aztreonam	64	≥ 256	0.5–≥ 256	0.5	91.2
Cefepime	≥ 32	≥ 32	≤ 0.12–≥ 32	3.2	85.5
Ceftazidime	32	≥ 256	0.25–≥ 256	5.9	79.7
Ceftazidime–avibactam	0.25	0.5	≤ 0.015–≥ 256	99.9	0.1
Colistin	0.25	1	0.12–≥ 16	96.6	3.4
Imipenem	0.25	0.5	0.06–≥ 16	98.1	0.6
Levofloxacin	≥ 16	≥ 16	0.03–≥ 16	18.0	71.7
Meropenem	0.03	0.12	0.008–8	98.6	0.0
Piperacillin–tazobactam	8	≥ 256	≤ 0.25–≥ 256	62.0	26.6
Tigecycline^b	0.25	1	≤ 0.015–≥ 16	N/A	N/A
Enterobacterales, carbapenemase-positive, MBL-negative (N = 46)
Amikacin	2	8	≤ 0.25–≥ 64	93.5	2.2
Amoxicillin–clavulanic acid	≥ 64	≥ 64	≥ 64–≥ 64	0.0	100
Aztreonam	≥ 256	≥ 256	8–≥ 256	0.0	100
Cefepime	≥ 32	≥ 32	≤ 0.12–≥ 32	4.3	91.3
Ceftazidime	128	≥ 256	8–≥ 256	0.0	100
Ceftazidime–avibactam	1	2	0.12–4	100	0.0
Colistin	0.25	≥ 16	0.12–≥ 16	87.0	13.0
Imipenem	8	≥ 16	0.5–≥ 16	23.9	67.4
Levofloxacin	≥ 16	≥ 16	0.06–≥ 16	10.9	82.6
Meropenem	≥ 16	≥ 16	0.5–≥ 16	26.1	58.7
Piperacillin–tazobactam	≥ 256	≥ 256	128–≥ 256	0.0	100
Tigecycline^b	0.5	1	0.12–≥ 16	N/A	N/A
Enterobacterales, carbapenemase-positive, MBL-positive (N = 121)
Amikacin	4	≥ 64	0.5–≥ 64	75.2	16.5
Amoxicillin–clavulanic acid	≥ 64	≥ 64	16–≥ 64	0.0	100
Aztreonam	128	≥ 256	≤ 0.015–≥ 256	12.4	81.8
Cefepime	≥ 32	≥ 32	2–≥ 32	0.0	94.2
Ceftazidime	≥ 256	≥ 256	32–≥ 256	0.0	100
Ceftazidime–avibactam	≥ 256	≥ 256	32–≥ 256	0.0	100
Colistin	0.5	1	≤ 0.06–≥ 16	93.4	6.6
Imipenem	≥ 16	≥ 16	1–≥ 16	13.2	77.7
Levofloxacin	≥ 16	≥ 16	0.06–≥ 16	11.6	81.8
Meropenem	≥ 16	≥ 16	0.5–≥ 16	9.9	71.1
Piperacillin–tazobactam	≥ 256	≥ 256	1–≥ 256	7.4	90.9
Tigecycline^b	0.5	4	0.12–8	N/A	N/A
E. coli (N = 2218)
Amikacin	2	8	≤ 0.25–≥ 64	97.1	0.6
Amoxicillin–clavulanic acid	8	32	≤ 0.12–≥ 64	55.7	44.3
Aztreonam	0.12	64	≤ 0.015–≥ 256	62.4	32
Cefepime	≤ 0.12	≥ 32	≤ 0.12–≥ 32	67.6	27.6
Ceftazidime	0.25	32	≤ 0.015–≥ 256	64.0	28.4
Ceftazidime–avibactam	0.12	0.25	≤ 0.015–≥ 256	99.4	0.6
Colistin	0.25	0.5	≤ 0.06–≥ 16	99.3	0.7
Imipenem	0.12	0.25	≤ 0.03–≥ 16	99.2	0.7
Levofloxacin	0.5	≥ 16	≤ 0.004–≥ 16	50.6	45.4
Meropenem	0.03	0.06	0.008–≥ 16	99.1	0.5
Piperacillin–tazobactam	2	16	≤ 0.25–≥ 256	89.0	7.3
Tigecycline^b	0.25	0.5	0.03–≥ 16	97.7	2.3
E. coli, ESBL-positive, carbapenemase-negative (N = 668)
Amikacin	4	8	0.5–≥ 64	92.8	1.2
Amoxicillin–clavulanic acid	16	32	1–≥ 64	36.4	63.6
Aztreonam	32	128	0.5–≥ 256	0.1	88.9
Cefepime	≥ 32	≥ 32	≤ 0.12–≥ 32	1.6	86.8
Ceftazidime	16	64	0.25–≥ 256	8.4	70.1
Ceftazidime–avibactam	0.12	0.25	≤ 0.015–4	100	0.0
Colistin	0.25	0.5	0.12–8	98.4	1.6
Imipenem	0.12	0.25	0.06–≥ 16	99.7	0.3
Levofloxacin	≥ 16	≥ 16	0.03–≥ 16	14.2	81.9
Meropenem	0.03	0.06	0.008–8	99.6	0.0
Piperacillin–tazobactam	4	32	≤ 0.25–≥ 256	82.2	10.0
Tigecycline^b	0.25	0.5	0.03–≥ 16	96.9	3.1
E. coli, carbapenemase-positive, MBL-positive (N = 14)
Amikacin	4	≥ 64	2–≥ 64	71.4	21.4
Amoxy/clav	≥ 64	≥ 64	32–≥ 64	0.0	100
Aztreonam	≥ 256	≥ 256	0.12–≥ 256	7.1	92.9
Cefepime	≥ 32	≥ 32	≥ 32–≥ 32	0.0	100
Ceftazidime	≥ 256	≥ 256	128–≥ 256	0.0	100
Ceftazidime–avibactam	≥ 256	≥ 256	64–≥ 256	0.0	100
Colistin	0.25	1	0.12–1	100	0.0
Imipenem	≥ 16	≥ 16	2–≥ 16	7.1	92.9
Levofloxacin	≥ 16	≥ 16	1–≥ 16	0.0	92.9
Meropenem	≥ 16	≥ 16	4–≥ 16	0.0	78.6
Pip/taz	≥ 256	≥ 256	64–≥ 256	0.0	100
Tigecycline^b	0.25	0.5	0.12–2	92.9	7.1
K. pneumoniae (N = 2082)
Amikacin	1	4	≤ 0.25–≥ 64	95.6	2.5
Amoxicillin–clavulanic acid	4	≥ 64	≤ 0.12–≥ 64	64.0	36.0
Aztreonam	0.12	≥ 256	≤ 0.015–≥ 256	66.1	31.3
Cefepime	≤ 0.12	≥ 32	≤ 0.12–≥ 32	69.7	26.7
Ceftazidime	0.25	≥ 256	≤ 0.015–≥ 256	65.0	32.4
Ceftazidime–avibactam	0.12	0.5	≤ 0.015–≥ 256	97.5	2.5
Colistin	0.25	1	≤ 0.06–≥ 16	98.1	1.9
Imipenem	0.25	1	≤ 0.03–≥ 16	95.5	3.8
Levofloxacin	0.12	≥ 16	0.008–≥ 16	65.4	25.9
Meropenem	0.06	0.12	0.008–≥ 16	95.4	3.3
Piperacillin–tazobactam	4	≥ 256	≤ 0.25–≥ 256	73.0	21.0
Tigecycline^b	0.5	1	≤ 0.015–≥ 16	N/A	N/A
K. pneumoniae, ESBL-positive, carbapenemase-negative (N = 532)
Amikacin	2	16	≤ 0.25–≥ 64	89.1	6.2
Amoxicillin–clavulanic acid	16	≥ 64	2–≥ 64	11.8	88.2
Aztreonam	128	≥ 256	0.5–≥ 256	0.6	95.1
Cefepime	≥ 32	≥ 32	≤ 0.12–≥ 32	3.4	86.1
Ceftazidime	64	≥ 256	0.25–≥ 256	2.4	91.9
Ceftazidime–avibactam	0.25	1	≤ 0.015–≥ 256	99.8	0.2
Colistin	0.25	1	0.12–≥ 16	96.8	3.2
Imipenem	0.25	1	0.06–≥ 16	98.7	0.8
Levofloxacin	8	≥ 16	0.03–≥ 16	20.3	62.8
Meropenem	0.06	0.12	0.015–8	97.6	0.0
Piperacillin–tazobactam	16	≥ 256	1–≥ 256	35.5	48.5
Tigecycline^b	0.5	2	≤ 0.015–≥ 16	N/A	N/A
K. pneumoniae, carbapenemase-positive, MBL-negative (N = 39)
Amikacin	2	4	≤ 0.25–≥ 64	94.9	2.6
Amoxicillin–clavulanic acid	≥ 64	≥ 64	≥ 64–≥ 64	0.0	100
Aztreonam	≥ 256	≥ 256	8–≥ 256	0.0	100
Cefepime	≥ 32	≥ 32	≤ 0.12–≥ 32	5.1	92.3
Ceftazidime	128	≥ 256	32–≥ 256	0.0	100
Ceftazidime–avibactam	1	2	0.12–4	100	0.0
Colistin	0.25	≥ 16	0.25–≥ 16	87.2	12.8
Imipenem	8	≥ 16	0.5–≥ 16	20.5	69.2
Levofloxacin	≥ 16	≥ 16	0.06–≥ 16	5.1	87.2
Meropenem	≥ 16	≥ 16	0.5–≥ 16	23.1	61.5
Piperacillin–tazobactam	≥ 256	≥ 256	128–≥ 256	0.0	100
Tigecycline^b	0.5	2	0.25–≥ 16	N/A	N/A
K. pneumoniae, carbapenemase-positive, MBL-positive (N = 52)
Amikacin	4	≥ 64	0.5–≥ 64	67.3	17.3
Amoxicillin–clavulanic acid	≥ 64	≥ 64	16–≥ 64	0.0	100
Aztreonam	128	≥ 256	0.06–≥ 256	3.8	94.2
Cefepime	≥ 32	≥ 32	4–≥ 32	0.0	94.2
Ceftazidime	≥ 256	≥ 256	128–≥ 256	0.0	100
Ceftazidime– avibactam	≥ 256	≥ 256	32–≥ 256	0.0	100
Colistin	0.5	1	0.12–≥ 16	94.2	5.8
Imipenem	≥ 16	≥ 16	1–≥ 16	5.8	88.5
Levofloxacin	≥ 16	≥ 16	0.25–≥ 16	3.8	86.5
Meropenem	≥ 16	≥ 16	2–≥ 16	1.9	84.6
Piperacillin–tazobactam	≥ 256	≥ 256	16–≥ 256	0.0	96.2
Tigecycline^b	1	4	0.12–8	N/A	N/A

^aEnterobacterales isolates (N = 7051) comprised: Citrobacter amalonaticus, 9; Citrobacter braakii, 22; Citrobacter farmeri, 8; Citrobacter freundii, 311; Citrobacter koseri, 231; Citrobacter murliniae, 1; Citrobacter sedlakii, 2; Enterobacter asburiae, 63; Enterobacter cloacae, 439; Enterobacter kobei, 22; Enterobacter ludwigii, 6; Enterobacter, non-speciated, 1; Escherichia coli, 2218; Klebsiella aerogenes, 287; Klebsiella oxytoca, 308; Klebsiella pneumoniae, 2082; Klebsiella variicola, 47; Morganella morganii, 164; Pluralibacter gergoviae, 6; Proteus hauseri, 56; Proteus mirabilis, 357; Proteus penneri, 7; Proteus vulgaris, 151; Providencia rettgeri, 61; Providencia stuartii, 65; Raoultella ornithinolytica, 5; Raoultella planticola, 1; Serratia liquefaciens, 2; Serratia marcescens, 118 and Serratia, non-speciated, 1
^bEUCAST breakpoints for tigecycline are only available with E. coli

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