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Evaluation of Low-cost, Manual Techniques for Rapid Detection of Ceftazidime-avibactam Susceptibility against Carbapenem-Resistant Enterobacterales

Article

Last updated: 20 Jan 2025

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Subjects

-

Tags

Clinical microbiology

Abstract

Background: Ceftazidime-avibactam (CAZ–AVI) is a new effective therapeutic combination that exhibits exceptional efficacy against clinically significant serine β-lactam-resistant bacteria. Emergence of CAZ–AVI resistance has been observed in carbapenem-resistant Enterobacterales (CRE). Therefore, rapid and accurate detection of CAZ–AVI susceptibility is time-saving for clinical treatment measures. Objective: To assess the efficacy and usage in clinical setting of two low-cost, rapid simple manual methods for screening of CAZ-AVI activity against CRE, to restrict spread of diseases and drug resistance through the implementation of rapid infection control programs.  Methodology: The susceptibility of CAZ-AVI among CRE isolates was assessed using Rapid CAZ/AVI NP and Rapid ResaCeftazidime-avibactam-Enterobacterales NP tests along with broth microdilution method (BMD). Vitek- 2 compact was utilized to identify CRE isolates and CAZ/AVI sensitivity using GN and AST cards and Gene-Xpert system was used to determine the type of carbapenemase encoding genes. Results: This study utilized a total of 93 CRE isolates.  Rapid CAZ/AVI NP test enabled the detection of CRE susceptibility to CAZ/AVI within three hours, with an overall percent agreement (OPA) of 97.9%, 2.8% major errors (MEs) and 0% very major errors (VMEs). In contrast, Rapid ResaCeftazidime-avibactam Enterobacterales NP test can be interpreted after 4 hours with an OPA of 98.9%, 1.4% MEs and 0% VMEs. Conclusion: These screening manual tests were rapid, simple, straightforward and easily applicable in routine microbiology laboratories. These tests are anticipated to be valuable tools for rapid clinical screening of CAZ-AVI susceptibility after further optimization of the test conditions in the near future.

DOI

10.21608/ejmm.2025.347909.1417

Keywords

Ceftazidime-avibactam susceptibility testing, CAZ–AVI resistance, Enterobacterales, CRE

Authors

First Name

Salah

Last Name

Ali

MiddleName

A.I.

Affiliation

Clinical Pathology Department, Faculty of Medicine, Zagazig University, Sharqia, Egypt

Email

salah24sms@gmail.com

City

-

Orcid

-

First Name

Aya

Last Name

Ghamry

MiddleName

A.

Affiliation

Medical Microbiology and Immunology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt

Email

ayaahmed.micro@azhar.edu.eg

City

-

Orcid

-

First Name

Alyaa

Last Name

El-Zayaat

MiddleName

M.

Affiliation

Anesthesia, Intensive Care, and Pain management Department, Faculty of Medicine, Zagazig University, Sharqia, Egypt

Email

hazemhabiba242@gmail.com

City

-

Orcid

-

First Name

Fatma

Last Name

Al-Sayed

MiddleName

M.A.

Affiliation

Internal Medicine Department, Faculty of Medicine, Zagazig University, Sharqia, Egypt

Email

fmatyaa@medicine.zu.edu.eg

City

-

Orcid

-

First Name

Fatma

Last Name

Ibrahim

MiddleName

A.

Affiliation

Clinical Pathology Department, Faculty of Medicine, Zagazig University, Sharqia, Egypt

Email

fatmaatefibrahim@gmail.com

City

-

Orcid

-

Volume

34

Article Issue

2

Related Issue

51523

Issue Date

2025-04-01

Receive Date

2024-12-26

Publish Date

2025-04-01

Print ISSN

1110-2179

Online ISSN

2537-0979

Link

https://ejmm.journals.ekb.eg/article_404896.html

Detail API

http://journals.ekb.eg?_action=service&article_code=404896

Order

404,896

Type

New and original researches in the field of Microbiology.

Type Code

2,038

Publication Type

Journal

Publication Title

Egyptian Journal of Medical Microbiology

Publication Link

https://ejmm.journals.ekb.eg/

MainTitle

Evaluation of Low-cost, Manual Techniques for Rapid Detection of Ceftazidime-avibactam Susceptibility against Carbapenem-Resistant Enterobacterales

Details

Type

Article

Created At

20 Jan 2025