The importance of monitoring a novel antibiotic: National surveillance of ceftazidime-avibactam resistance and usage in England, 2016-2018
PHE ePoster Library. Wilson K. 09/12/19; 274405; 205
Kate Wilson
Kate Wilson
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Abstract
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Abstract BackgroundCeftazidime-avibactam (CAZ-AVI) is a cephalosporin/β-lactamase inhibitor, licenced in 2015 to treat complicated and hospital-acquired infections caused by multi-drug resistant Gram-negative bacteria (GNB), such as carbapenem-resistant Enterobacterales (CRE). It is active against KPC and OXA-48-like carbapenemases but not against metallo-β-lactamases (MBLs). CAZ-AVI was launched in the UK in March 2017. We describe CAZ-AVI resistance and usage in England.
Methods
Routine laboratory records of CAZ-AVI susceptibility and PHE Antimicrobial Resistance and Healthcare-Associated Infections reference laboratory (AMRHAI) CAZ-AVI MIC and carbapenemase gene data were analysed for GNB from March 2016-October 2018 and April 2016-March 2018, respectively. National CAZ-AVI usage by NHS hospitals was obtained for January 2017–September 2018.
Results
Reports of routine CAZ-AVI susceptibility test results increased from 5 in 2016 (March-December) to 11,951 in 2018 (January-October). Eleven percent (224/2,133) of Klebsiella spp. isolates tested, 4.1% (150/3,619) of Escherichia coli and 14.1% (747/5,297) of Pseudomonas aeruginosa were reported as CAZ-AVI resistant.AMRHAI determined CAZ-AVI MIC for 5,640 Enterobacterales: 711/5,640 (12.6%) isolates were resistant to CAZ-AVI, with resistance observed in 18/623 (2.9%) of non-MBL-producing CRE.National monthly usage of CAZ-AVI increased from 21 Daily Defined Doses (DDD) in March 2017 to 588 DDDs in September 2018 and has been used by 38% (56/151) of Trusts.
Conclusions
Routine and reference laboratory testing have highlighted the presence of CAZ-AVI resistance in England including among non-MBL-producing CRE. Usage of CAZ-AVI is low in England but has steadily increased. The findings emphasise the importance of vigilance to detect emerging resistance and strengthening surveillance. External funding details
Abstract BackgroundCeftazidime-avibactam (CAZ-AVI) is a cephalosporin/β-lactamase inhibitor, licenced in 2015 to treat complicated and hospital-acquired infections caused by multi-drug resistant Gram-negative bacteria (GNB), such as carbapenem-resistant Enterobacterales (CRE). It is active against KPC and OXA-48-like carbapenemases but not against metallo-β-lactamases (MBLs). CAZ-AVI was launched in the UK in March 2017. We describe CAZ-AVI resistance and usage in England.
Methods
Routine laboratory records of CAZ-AVI susceptibility and PHE Antimicrobial Resistance and Healthcare-Associated Infections reference laboratory (AMRHAI) CAZ-AVI MIC and carbapenemase gene data were analysed for GNB from March 2016-October 2018 and April 2016-March 2018, respectively. National CAZ-AVI usage by NHS hospitals was obtained for January 2017–September 2018.
Results
Reports of routine CAZ-AVI susceptibility test results increased from 5 in 2016 (March-December) to 11,951 in 2018 (January-October). Eleven percent (224/2,133) of Klebsiella spp. isolates tested, 4.1% (150/3,619) of Escherichia coli and 14.1% (747/5,297) of Pseudomonas aeruginosa were reported as CAZ-AVI resistant.AMRHAI determined CAZ-AVI MIC for 5,640 Enterobacterales: 711/5,640 (12.6%) isolates were resistant to CAZ-AVI, with resistance observed in 18/623 (2.9%) of non-MBL-producing CRE.National monthly usage of CAZ-AVI increased from 21 Daily Defined Doses (DDD) in March 2017 to 588 DDDs in September 2018 and has been used by 38% (56/151) of Trusts.
Conclusions
Routine and reference laboratory testing have highlighted the presence of CAZ-AVI resistance in England including among non-MBL-producing CRE. Usage of CAZ-AVI is low in England but has steadily increased. The findings emphasise the importance of vigilance to detect emerging resistance and strengthening surveillance. External funding details
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