TY - JOUR
T1 - In vitro activity of plazomicin compared to amikacin, gentamicin, and tobramycin against multidrug-resistant aerobic gram-negative bacilli
AU - Fleischmann, Wim A.
AU - Greenwood-Quaintance, Kerryl E.
AU - Patel, Robin
N1 - Publisher Copyright:
© 2020 American Society for Microbiology. All rights reserved.
PY - 2020/1/27
Y1 - 2020/1/27
N2 - The worldwide spread of multidrug-resistant Enterobacterales is a serious threat to public health. Here, we compared the MICs of plazomicin, amikacin, gentamicin, and tobramycin against 303 multinational multidrug-resistant Gramnegative bacilli. We followed Clinical and Laboratory Standards Institute (CLSI) guidelines and applied CLSI breakpoints as well as those of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) for amikacin, gentamicin, and tobramycin and of the U.S. Food and Drug Administration for plazomicin. Overall, the highest percentage of susceptible isolates (80.2%) was demonstrated for plazomicin, which had the lowest MIC50 (1 ≥g/ml) of the aminoglycosides studied. Of the 42 isolates resistant to plazomicin, 34 had MICs of 128 ≥g/ml, with 33 of the 34 having MICs of ≥128 ≥g/ml for amikacin, gentamicin, and tobramycin. Among the 42 blaNDM-positive isolates, 35.7% were plazomicin susceptible, with the percentage of isolates susceptible to amikacin being 38.1% or 35.7% when applying the CLSI or EUCAST breakpoint, respectively. The 20 blaOXA-48-like-positive isolates showed 50.0% susceptibility to plazomicin. Among 35 isolates with blaCTX-M as their only characterized resistance mechanism, 68.6% were plazomicin susceptible, while the percentage susceptible to amikacin was 74.3% or 62.9% when applying the CLSI or EUCAST breakpoint, respectively. Among the 117 blaKPC-positive isolates, 94.9% were susceptible to plazomicin, whereas when the CLSI and EUCAST breakpoints were applied, 43.6% and 25.6%, respectively, were susceptible to amikacin; 56.4% and 44.4%, respectively, were susceptible to gentamicin; and 5.1% and 4.3%, respectively, were susceptible to tobramycin.
AB - The worldwide spread of multidrug-resistant Enterobacterales is a serious threat to public health. Here, we compared the MICs of plazomicin, amikacin, gentamicin, and tobramycin against 303 multinational multidrug-resistant Gramnegative bacilli. We followed Clinical and Laboratory Standards Institute (CLSI) guidelines and applied CLSI breakpoints as well as those of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) for amikacin, gentamicin, and tobramycin and of the U.S. Food and Drug Administration for plazomicin. Overall, the highest percentage of susceptible isolates (80.2%) was demonstrated for plazomicin, which had the lowest MIC50 (1 ≥g/ml) of the aminoglycosides studied. Of the 42 isolates resistant to plazomicin, 34 had MICs of 128 ≥g/ml, with 33 of the 34 having MICs of ≥128 ≥g/ml for amikacin, gentamicin, and tobramycin. Among the 42 blaNDM-positive isolates, 35.7% were plazomicin susceptible, with the percentage of isolates susceptible to amikacin being 38.1% or 35.7% when applying the CLSI or EUCAST breakpoint, respectively. The 20 blaOXA-48-like-positive isolates showed 50.0% susceptibility to plazomicin. Among 35 isolates with blaCTX-M as their only characterized resistance mechanism, 68.6% were plazomicin susceptible, while the percentage susceptible to amikacin was 74.3% or 62.9% when applying the CLSI or EUCAST breakpoint, respectively. Among the 117 blaKPC-positive isolates, 94.9% were susceptible to plazomicin, whereas when the CLSI and EUCAST breakpoints were applied, 43.6% and 25.6%, respectively, were susceptible to amikacin; 56.4% and 44.4%, respectively, were susceptible to gentamicin; and 5.1% and 4.3%, respectively, were susceptible to tobramycin.
KW - Antimicrobial resistance
KW - Enterobacterales
KW - Plazomicin
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U2 - 10.1128/AAC.01711-19
DO - 10.1128/AAC.01711-19
M3 - Article
C2 - 31712206
AN - SCOPUS:85078563792
SN - 0066-4804
VL - 64
JO - Antimicrobial Agents and Chemotherapy
JF - Antimicrobial Agents and Chemotherapy
IS - 2
M1 - e01711
ER -