Antimicrobial activity of ceftazidime-avibactam and comparator agents when tested against bacterial isolates causing infection in cancer patients (2013-2014)

We evaluated the antimicrobial susceptibility of 623 Gram-negative organisms causing infection in patients with cancer in 52 United States hospitals (2013-2014) as part of the International Network for Optimal Resistance Monitoring (INFORM) program. Isolates were tested for susceptibility by broth microdilution method. β-lactamase encoding genes were evaluated for all Escherichia coli and Klebsiella spp. with an extended-spectrum β-lactamase (ESBL) phenotype by microarray-based assay. ESBL-phenotype was observed among 17.3 and 9.9% of E. coli and Klebsiella pneumoniae, respectively; and 25.0% of Enterobacter cloacae were ceftazidime-non-susceptible. All Enterobacteriaceae (n = 486) were susceptible to ceftazidime-avibactam (MIC50/90, 0.12/0.25 μg/mL) with the highest MIC value at 1 μg/mL. Meropenem was active against Enterobacteriaceae overall (MIC50/90, ≤0.06/≤0.06 μg/mL; 99.6% susceptible); but showed more limited activity against Klebsiella spp. with an ESBL-phenotype (84.6% susceptible) and multidrug-resistant Enterobacteriaceae (93.3% susceptible). The most active agents tested against Pseudomonas aeruginosa were colistin (100.0% susceptible), amikacin (97.7% susceptible) and ceftazidime-avibactam (96.6% susceptible).