sdü tıp fak derg

Medical Journal of Süleyman Demirel University

2602-2109

Süleyman Demirel Üniversitesi

10.17343/sdutfd.1748282

Medical Bacteriology

Tıbbi Bakteriyoloji

Evaluation of Ceftazidime-Avibactam Susceptibility in Carbapenem-Resistant Gram-Negative Bacteria

https://orcid.org/0000-0003-0958-1502

Ayvalik Rüzgarkesen

Tuğba

Cizre Dr. Selahattin Cizrelioğlu Devlet Hastanesi

https://orcid.org/0009-0001-6114-9859

Şekercioğlu

Yaren

Antalya Eğitim ve Araştırma Hastanesi

https://orcid.org/0009-0007-3209-8347

Erol

Muhammed Tevfik

SULEYMAN DEMIREL UNIVERSITY, SCHOOL OF MEDICINE

https://orcid.org/0000-0002-0375-4188

Bilir

Göksel

SULEYMAN DEMIREL UNIVERSITY, SCHOOL OF MEDICINE

https://orcid.org/0000-0001-5231-3824

Sesli Çetin

Emel

SULEYMAN DEMIREL UNIVERSITY, SCHOOL OF MEDICINE

https://orcid.org/0000-0002-7349-3438

Şirin

Mümtaz Cem

SULEYMAN DEMIREL UNIVERSITY, SCHOOL OF MEDICINE

12 01 2025

32 4 319 326 07 22 2025 10 08 2025

1994

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Objective: Resistance to carbapenem antibiotics, commonly preferred to treat infections caused by multidrug-resistant (MDR) Gram-negative bacteria, is gradually increasing. Ceftazidime-avibactam (CZA) is a novel beta-lactam/beta-lactamase inhibitor combination, proposed as an alternative treatment option for severe infections caused by carbapenem-resistant Gram-negative bacteria. This study aimed to determine the susceptibility of carbapenem-resistant Klebsiella pneumoniae (CR-KP), carbapenem-resistant Escherichia coli (CR-EC), and carbapenem-resistant Pseudomonas aeruginosa (CR-PA) isolates to CZA using the Kirby-Bauer disk diffusion method (DDM) and the BD Phoenix automated system, and to compare the results.Material and Method: A total of 320 strains (209 CR-KP, 53 CR-EC, and 58 CR-PA) resistant to at least one carbapenem (ertapenem, imipenem, and meropenem), collected between August 2021 and August 2023, were included in the study. CZA susceptibility testing was performed using the DDM and the CPO detect panel of the BD Phoenix automated system (Becton Dickinson, USA). Results were interpreted in accordance with the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standards. Results: While CZA susceptibility rates determined by the automated system were 74.1% for CR-KP, 64.5% for CR-EC, and 90.9% for CR-PA, the DDM method yielded susceptibility rates of 87.8% for CR-KP, 94.4% for CR-EC, and 81.3% for CR-PA. Categorical agreement was observed in 86.9% of 115 isolates tested by both methods. Although not statistically significant, a declining trend in CZA susceptibility was observed over the years with both methods.Conclusion: CZA susceptibility rates among carbapenem-resistant Gram-negative isolates in our hospital were consistent with current global data. Determining accurate CZA susceptibility results is important for guiding effective treatment strategies against infections caused by carbapenem-resistant bacteria. The observed discrepancies in susceptibility results between the DDM and the automated system, particularly across different species, underscore the need for further species-specific studies to identify the most reliable testing methodology for CZA susceptibility.

ceftazidime-avibactam antibiotic susceptibility test automated system disk diffusion method

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