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Journals / Journal of Health Sciences and Medicine / 2026 / Volume: 8 Issue: 1

Evaluation of the In vitro efficacy of ceftazidime-avibactam against Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa isolates from respiratory tract cultures in intensive care units

Yoğun bakım ünitelerinde solunum yolu kültürlerinden izole edilen Escherichia coli, Klebsiella pneumoniae ve Pseudomonas aeruginosa'ya karşı seftazidim-avibaktamın in vitro etkinliğinin değerlendirilmesi

Emine Serap Yılmaz(ORDU ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0001-5308-4488
Hacer Özlem Kalaycı(ORDU ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0003-2358-6764
Pages
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Publication Date
2025-01-12
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Conclusion: In our study, CZA was found to be the most effective antibiotic against multidrug-resistant Enterobacterales and P. aeruginosa isolates, followed by colistin.

📌 3 Key Takeaways

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Objective & Hypothesis:Aims: Worldwide, an increase in multidrug resistance is observed in Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Pseudomonas aeruginosa (P. aeruginosa) isolates, leading to challenges in the treatment of infections caused by these pathogens.
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Key Findings & Data:Methods: A retrospective analysis was conducted on 653 Enterobacterales (E. coli, K. pneumoniae) and P. aeruginosa isolates obtained from respiratory tract cultures, including sputum, tracheal aspirates, and bronchial lavage, from patients over 18 years old admitted to the intensive care units of Ordu University Training and Research Hospital between May 1, 2021, and May 1, 2024.
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Conclusion & Impact:Conclusion: In our study, CZA was found to be the most effective antibiotic against multidrug-resistant Enterobacterales and P. aeruginosa isolates, followed by colistin.
🔬Design:Research Article
📍Scope:2021 Verileri
⚙️Variables:Multidrug resistance · Escherichia coli · Klebsiella pneumoniae

Abstract

Aims: Worldwide, an increase in multidrug resistance is observed in Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Pseudomonas aeruginosa (P. aeruginosa) isolates, leading to challenges in the treatment of infections caused by these pathogens. This study aims to investigate the in vitro efficacy of ceftazidime-avibactam (CZA) against isolates containing K. pneumoniae, E. coli, and P. aeruginosa strains obtained from respiratory tract samples sent from intensive care units. Methods: A retrospective analysis was conducted on 653 Enterobacterales (E. coli, K. pneumoniae) and P. aeruginosa isolates obtained from respiratory tract cultures, including sputum, tracheal aspirates, and bronchial lavage, from patients over 18 years old admitted to the intensive care units of Ordu University Training and Research Hospital between May 1, 2021, and May 1, 2024. Automated systems were used to identify the pathogens and perform antibiotic susceptibility testing. Discriptive data analysis was conducted using SPSS version 24.0. Results: A total of 653 isolates from respiratory tract samples were included in the study, consisting of 368 Enterobacteriaceae [61 E. coli (9.3%) and 307 K. pneumoniae (47%)] and 285 P. aeruginosa (43.7%). These samples were isolated from endotracheal aspirate (69.5%), sputum (27.9%), and bronchoalveolar lavage (2.6%). Among all isolates, 364 (55.7%) were found to be sensitive to carbapenems, while 289 (44.3%) were carbapenem-resistant. Of the samples, 631 (96.6%) were sensitive to CZA, while 22 (3.4%) were resistant. Although resistance to CZA was detected in 3.6% of K. pneumoniae isolates and 3.9% of P. aeruginosa isolates, no resistance was detected in E. coli. Colistin resistance was observed in 15.3% of K. pneumoniae and 5.6% of P. aeruginosa isolates, but was absent in E. coli isolates. Resistance rates to other antibiotics were as follows for E. coli, K. pneumoniae, and P. aeruginosa isolates, respectively: amikacin (3.3%, 46.6%, 8.1%), ciprofloxacin (73.8%, 73.6%, 85.9%), ceftazidime (67.2%, 77.8%, 35.8%), piperacillin-tazobactam (26.2%, 70%, 37.2%), and trimethoprim-sulfamethoxazole (52.5%, 66.4%, 0%). Conclusion: In our study, CZA was found to be the most effective antibiotic against multidrug-resistant Enterobacterales and P. aeruginosa isolates, followed by colistin.

Özet

Amaçlar: Dünya çapında, Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae) ve Pseudomonas aeruginosa (P. aeruginosa) izolatlarında çoklu ilaç direncinde artış gözlemlenmekte ve bu durum bu patojenlerin neden olduğu enfeksiyonların tedavisinde zorluklara yol açmaktadır. Bu çalışma, yoğun bakım ünitelerinden gönderilen solunum yolu örneklerinden elde edilen K. pneumoniae, E. coli ve P. aeruginosa suşlarını içeren izolatlara karşı seftazidim-avibaktamın (CZA) in vitro etkinliğini araştırmayı amaçlamaktadır. Yöntemler: 1 Mayıs 2021 ile 1 Mayıs 2024 tarihleri ​​arasında Ordu Üniversitesi Eğitim ve Araştırma Hastanesi yoğun bakım ünitelerine yatırılan 18 yaş üstü hastalardan alınan balgam, trakeal aspirat ve bronş lavajı gibi solunum yolu kültürlerinden elde edilen 653 Enterobacterales (E. coli, K. pneumoniae) ve P. aeruginosa izolatı retrospektif olarak analiz edildi. Patojenleri tanımlamak ve antibiyotik duyarlılık testlerini yapmak için otomatik sistemler kullanıldı. Tanımlayıcı veri analizi SPSS sürüm 24.0 kullanılarak yapıldı. Bulgular: Çalışmaya solunum yolu örneklerinden toplam 653 izolat dahil edildi. Bunlardan 368'i Enterobacteriaceae [61 E. coli (%9,3) ve 307 K. pneumoniae (%47)] ve 285'i P. aeruginosa (%43,7) idi. Bu örnekler endotrakeal aspirat (%69,5), balgam (%27,9) ve bronkoalveolar lavajdan (%2,6) izole edildi. Tüm izolatlar arasında 364 (%55,7) tanesinin karbapenemlere duyarlı, 289 (%44,3) tanesinin ise karbapenemlere dirençli olduğu bulundu. Örneklerin 631 (%96,6) tanesinin CZA'ya duyarlı, 22 (%3,4) tanesinin ise dirençli olduğu bulundu. K. pneumoniae izolatlarının %3,6'sında ve P. aeruginosa izolatlarının %3,9'unda CZA direnci saptanmasına karşın, E. coli'de direnç saptanmadı. Kolistin direnci K. pneumoniae izolatlarının %15,3'ünde ve P. aeruginosa izolatlarının %5,6'sında gözlendi, ancak E. coli izolatlarında yoktu. Diğer antibiyotiklere karşı direnç oranları E. coli, K. pneumoniae ve P. aeruginosa izolatları için sırasıyla şu şekildeydi: amikasin (%3,3, %46,6, %8,1), siprofloksasin (%73,8, %73,6, %85,9), seftazidim (%67,2, %77,8, %35,8), piperasilin-tazobaktam (%26,2, %70, %37,2) ve trimetoprim-sülfametoksazol (%52,5, %66,4, %0). Sonuç: Çalışmamızda, çoklu ilaca dirençli Enterobacterales ve P. aeruginosa izolatlarına karşı en etkili antibiyotik CZA olarak bulundu, bunu kolistin izledi.

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Cite This Article

Yılmaz, E. S., Kalaycı, H. Ö. (2025). Evaluation of the In vitro efficacy of ceftazidime-avibactam against Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa isolates from respiratory tract cultures in intensive care units. Journal of Health Sciences and Medicine, Volume: 8 Issue: 1. https://doi.org/10.32322/jhsm.1583801

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