Evidence map›Paper›PMID 39589655›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2025

In-vitro activity of newly-developed β-lactamase inhibitors avibactam, relebactam and vaborbactam in combination with anti-pseudomonal β-lactam antibiotics against AmpC-overproducing clinical Pseudomonas aeruginosa isolates.

Christophe Le Terrier, Otávio Hallal Ferreira Raro, Alaaeldin Mohamed Saad, Patrice Nordmann, Laurent Poirel

Abstract read
In one paragraph

Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed.

  1. Review
  2. Article
  3. A Review ofInternational journal of microbiology · 2026
    Review
  4. Article
  5. Article
  6. In-vitro activity of the novel β-lactam/β-lactamase inhibitor combinations and cefiderocol against carbapenem-resistant Pseudomonas spp. clinical isolates collected in Switzerland in 2022.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
    Article
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

5 authors.

Christophe Le TerrierEmerging Antibiotic Resistance Unit, Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Chemin du Musée 18, Fribourg, CH-1700, Switzerland.ORCID https://orcid.org/0000-0002-5455-5576
Otávio Hallal Ferreira RaroEmerging Antibiotic Resistance Unit, Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Chemin du Musée 18, Fribourg, CH-1700, Switzerland.ORCID https://orcid.org/0000-0001-7374-0788
Alaaeldin Mohamed SaadEmerging Antibiotic Resistance Unit, Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Chemin du Musée 18, Fribourg, CH-1700, Switzerland.
Patrice NordmannEmerging Antibiotic Resistance Unit, Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Chemin du Musée 18, Fribourg, CH-1700, Switzerland.ORCID https://orcid.org/0000-0002-1343-1622
Laurent PoirelEmerging Antibiotic Resistance Unit, Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Chemin du Musée 18, Fribourg, CH-1700, Switzerland. laurent.poirel@unifr.ch.ORCID https://orcid.org/0000-0001-5160-5286

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOverproduction of the intrinsic chromosomally-encoded AmpC β-lactamase is one of the main mechanisms responsible for broad-spectrum β-lactam resistance in Pseudomonas aeruginosa. Our study aimed to evaluate the in-vitro activity of anti-pseudomonal β-lactam molecules associated with the recently-developed and commercially-available β-lactamase inhibitors, namely avibactam, relebactam and vaborbactam, against P. aeruginosa isolates overproducing their AmpC.

methodsMIC values of ceftazidime, cefepime, meropenem, imipenem and ceftolozane with or without β-lactam inhibitor were determined for 50 AmpC-overproducing P. aeruginosa clinical isolates. MIC breakpoints for resistance were retained at 8 mg/L for β-lactams and β-lactam/β-lactamase inhibitor combinations containing ceftazidime, cefepime and meropenem, while 4 mg/L was used for those containing imipenem and ceftolozane. The concentration of all β-lactamases inhibitors was fixed at 4 mg/L, except for vaborbactam (8 mg/L).

resultsThe rates of isolates not being resistant to ceftazidime, cefepime, meropenem, imipenem and ceftolozane were found at 12%, 22%, 34%, 8% and 74%, respectively. When combined with avibactam, those rates increased to 60%, 62%, 60%, 46%, and 80%, respectively. The highest rates were found with relebactam-based combinations, being 76%, 64%, 66%, 76% and 84%, respectively. By contrast, associations with vaborbactam did not lead to significantly increased "non-resistance" rates.

conclusionOur results showed that all combinations including relebactam led to higher "non-resistance" rates against AmpC-overproducing P. aeruginosa clinical isolates. The best activity was achieved by combining ceftolozane and relebactam, that might therefore be considered as an excellent clinical alternative against AmpC overproducers.

Indexed as

Anti-Bacterial AgentsAzabicyclo CompoundsBacterial Proteinsbeta-Lactamase Inhibitorsbeta-Lactamasesbeta-LactamsBoronic AcidsPseudomonas aeruginosabeta Lactam AntibioticsHumansMicrobial Sensitivity TestsPseudomonas InfectionsAmpC beta-lactamasesAnti-Bacterial AgentsavibactamAzabicyclo CompoundsBacterial Proteinsbeta Lactam Antibioticsbeta-Lactamase Inhibitorsbeta-Lactamasesbeta-LactamsBoronic AcidsrelebactamvaborbactamAmpC overproducingAntimicrobial resistanceAvibactamCarbapenemCeftolozaneCephalosporinsPseudomonas aeruginosaRelebactamVaborbactamβ-lactamases inhibitors

Identifiers

PMID39589655
PMCPMC11754317

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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.