Evidence map›Paper›PMID 30534964›Full record

ArticleThe Journal of antimicrobial chemotherapy2019

Performance of ceftazidime/avibactam susceptibility testing methods against clinically relevant Gram-negative organisms.

E Wenzler, M Lee, T J Wu, K A Meyer, R K Shields, M H Nguyen, C J Clancy, R M Humphries, A T Harrington

Abstract readComparative StudyEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

E WenzlerCollege of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
M LeeCollege of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
T J WuCollege of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
K A MeyerCollege of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
R K ShieldsDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
M H NguyenDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
C J ClancyDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
R M HumphriesAccelerate Diagnostics, Inc., Tucson, AZ, USA.
A T HarringtonLoyola University Medical Center, Maywood, IL, USA.

Funding

Caspofungin pharmacokinetics-pharmacodynamics during intra-adbominal candidiasisK08AI114883 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SHIELDS, RYAN K · 2015 to 2019
$858k
NIAID NIH HHS K08 AI114883
6 · The paper itself

Abstract

objectivesTo ensure the accuracy of susceptibility testing methods for ceftazidime/avibactam.

methodsThe performances of the Etest (bioMérieux), 30/20 μg disc (Hardy diagnostics) and 10/4 μg disc (Mast Group) were evaluated against the reference broth microdilution (BMD) method for 102 clinically relevant Gram-negative organisms: 69 ceftazidime- and meropenem-resistant Klebsiella pneumoniae and 33 MDR non-K. pneumoniae. Essential and categorical agreement along with major and very major error rates were determined according to CLSI guidelines.

resultsA total of 78% of isolates were susceptible to ceftazidime/avibactam. None of the three methods met the defined equivalency threshold against all 102 organisms. The Etest performed the best, with categorical agreement of 95% and major errors of 6.3%. Against the 69 ceftazidime- and meropenem-resistant K. pneumoniae, only the Etest and the 10/4 μg disc met the equivalency threshold. None of the three methods met equivalency for the 33 MDR isolates. There were no very major errors observed in any analysis. These results were pooled with those from a previous study of 74 carbapenem-resistant Enterobacteriaceae and data from the ceftazidime/avibactam new drug application to define optimal 30/20 μg disc thresholds using the error-rate bound model-based approaches of the diffusion breakpoint estimation testing software. This analysis identified a susceptibility threshold of ≤19 mm as optimal.

conclusionsOur data indicate that the Etest is a suitable alternative to BMD for testing ceftazidime/avibactam against ceftazidime- and meropenem-resistant K. pneumoniae. The 30/20 μg discs overestimate resistance and may lead to the use of treatment regimens that are more toxic and less effective.

Indexed as

Anti-Bacterial AgentsAzabicyclo Compoundsbeta-Lactamase Inhibitorsbeta-Lactam ResistanceCeftazidimeDrug CombinationsGram-Negative BacteriaGram-Negative Bacterial InfectionsHumansMicrobial Sensitivity TestsAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo Compoundsbeta-Lactamase InhibitorsCeftazidimeDrug Combinations

Identifiers

PMID30534964
PMCPMC6657273

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.