Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 31:14:3509-3518.
doi: 10.2147/IDR.S325520. eCollection 2021.

Susceptibility to Imipenem/Relebactam of Pseudomonas aeruginosa and Acinetobacter baumannii Isolates from Chinese Intra-Abdominal, Respiratory and Urinary Tract Infections: SMART 2015 to 2018

Hui Zhang #  1 , Peiyao Jia #  1   2 , Ying Zhu #  1   2 , Ge Zhang  1 , Jingjia Zhang  1 , Wei Kang  1 , Simeng Duan  1 , Weijuan Zhang  3 , Qiwen Yang  1 , Yingchun Xu  1
Affiliations

Susceptibility to Imipenem/Relebactam of Pseudomonas aeruginosa and Acinetobacter baumannii Isolates from Chinese Intra-Abdominal, Respiratory and Urinary Tract Infections: SMART 2015 to 2018

Hui Zhang et al. Infect Drug Resist. .

Abstract

Purpose: In recent years, less options are available for treating carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Pseudomonas aeruginosa. The present study investigates the susceptibility rates to imipenem/relebactam for the treatment of intra-abdominal infections (IAIs), respiratory tract infections (RTIs) and urinary tract infections (UTIs) caused by A. baumannii and P. aeruginosa in China.

Patients and methods: A total of 1886 P. aeruginosa and 1889 A. baumannii isolates were collected in 21 centers (7 regions) as a part of the global SMART surveillance program between 2015 and 2018. Antimicrobial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) recommendations using the broth microdilution methodology at Peking Union Medical College Hospital.

Results: For P. aeruginosa, overall susceptibility rates to imipenem/relebactam were 84.2% at a CLSI breakpoint of ≤2 mg/L compared to 55.7% for imipenem. Susceptibility rates of imipenem-non-susceptible P. aeruginosa to imipenem/relebactam were 64.4% and for multidrug-resistance (MDR) P. aeruginosa susceptibility rates were increased from 25.2% for imipenem to 65.8% for imipenem/relebactam. The susceptibilities of imipenem-non-susceptible and MDR P. aeruginosa strains were similarly restored by imipenem/relebactam in non-ICU and ICU wards. The rate of imipenem-non-susceptibilities A. baumannii isolates was 79.0%, whereas the MDR rate was 81.9%. Relebactam did not change the susceptibilities of imipenem-non susceptible or MDR A. baumannii isolates.

Conclusion: Imipenem/relebactam provides a therapy option to treat infections caused by MDR or imipenem-non-susceptible P. aeruginosa but not A. baumannii infections in China.

Keywords: carbapenem-resistance; carbapenemase; extended-spectrum β-lactamase; multidrug-resistance; β-lactamase inhibitor.

PubMed Disclaimer

Conflict of interest statement

Weijuan Zhang is an employee of MSD China. The other authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Effect of relebactam on MIC distribution of imipenem against: (A) P. aeruginosa isolates (n = 1886); (B) imipenem-non-susceptible P. aeruginosa (n = 835); (C) MDR P. aeruginosa isolates (n = 835). Dashed line represents the FDA identified susceptibility breakpoint of imipenem/relebactam of ≤ 2 mg/mL for P. aeruginosa.
Figure 2
Figure 2
Comparison of P. aeruginosa strain susceptibilities. From IAIs, UTIs and RTIs isolated (A) total P. aeruginosa, (B) imipenem-non-susceptible P. aeruginosa and (C) MDR P. aeruginosa strain susceptibilities to imipenem/relebactam, and imipenem. From ICUs and non-ICU departments isolated (D) total P. aeruginosa, (E) imipenem-non-susceptible P. aeruginosa and (F) MDR P. aeruginosa strain susceptibilities to imipenem/relebactam, and imipenem.
Figure 3
Figure 3
Changes in the susceptibility of (A) P. aeruginosa, (B) MDR P. aeruginosa and (C) imipenem-non-susceptible P. aeruginosa to imipenem/relebactam over time in different regions of China (2015, 2016, 2017, 2018). Country map to show the incidence (%) of (D) MDR P. aeruginosa and (E) imipenem-non-susceptible P. aeruginosa in different regions of China from 2015 to 2018.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Rice LB. Progress and challenges in implementing the research on ESKAPE pathogens. Infect Control Hosp Epidemiol. 2010;31(Suppl 1):S7–10. - PubMed
    1. Antunes LCS, Visca P, Towner KJ. Acinetobacter baumannii: evolution of a global pathogen. Pathog Dis. 2014;71(3):292–301. doi:10.1111/2049-632X.12125 - DOI - PubMed
    1. Koulenti D, Tsigou E, Rello J. Nosocomial pneumonia in 27 ICUs in Europe: perspectives from the EU-VAP/CAP study. Eur J Clin Microbiol Infect Dis. 2017;36(11):1999–2006. doi:10.1007/s10096-016-2703-z - DOI - PubMed
    1. Chopra T, Marchaim D, Awali RA, et al. Epidemiology of bloodstream infections caused by Acinetobacter baumannii and impact of drug resistance to both carbapenems and ampicillin-sulbactam on clinical outcomes. Antimicrob Agents Chemother. 2013;57(12):6270–6275. doi:10.1128/AAC.01520-13 - DOI - PMC - PubMed
    1. Butler DA, Biagi M, Tan X, Qasmieh S, Bulman ZP, Wenzler E. Multidrug resistant acinetobacter baumannii: resistance by any other name would still be hard to treat. Curr Infect Dis Rep. 2019;21(12):46. doi:10.1007/s11908-019-0706-5 - DOI - PubMed

Grants and funding

This study was sponsored by funding from Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Further support was provided by Beijing Key Clinical Specialty for Laboratory Medicine-Excellent Project (grant number ZK201000) and the National Key Research and Development Program of China (grant numbers 2018YFC1200100, 2018YFC1200105).

LinkOut - more resources