Observational studyBMC infectious diseases2026
Comparison between the antimicrobial activity of colistin and ceftazidime-avibactam against multidrug-resistant Pseudomonas aeruginosa isolated from patients with ventilator-associated pneumonia in intensive care units of Kasr Al-Ainy hospitals.
Observational study in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWith the growing challenge of antibiotic resistance, evaluating the effectiveness of existing antimicrobials is crucial. This work aimed to compare the antimicrobial activity of colistin versus ceftazidime/avibactam (CAZ/AVI) against MDR P. aeruginosa. It also aimed to estimate the prevalence of P. aeruginosa as a causative agent for VAP and the rate of its multi-drug resistance.
methodsThis observational cross-sectional study was conducted from January to June 2025 on ICU patients with VAP at Kasr Alainy Hospitals. A total of 120 endotracheal aspirates were collected from patients and cultured. P. aeruginosa was identified, tested for antibiotic susceptibility by the Kirby-Bauer disc diffusion method, and underwent colistin minimal inhibitory concentration (MIC) testing via broth microdilution and CAZ/AVI MIC determination using E-test, following the Clinical and Laboratory Standards Institute 2025 guidelines.
resultsOf 120 ICU patients diagnosed with VAP, P. aeruginosa was isolated from 47 (39.2%). Among these, 40 isolates (85.1%) were identified as MDR. Of 40 MDR P. aeruginosa isolates, 32 (80%) were susceptible to colistin, with MIC₅₀ and MIC₉₀ values of 2 µg/mL and 4 µg/mL, respectively. In contrast, only 5 (12.5%) isolates were susceptible to CAZ/AVI, with both MIC₅₀ and MIC₉₀ exceeding 16 µg/ml, indicating widespread resistance. The difference in susceptibility between the two antibiotics was statistically significant (p < 0.01).
conclusionsColistin showed significantly greater in vitro effectiveness than CAZ/AVI against MDR P. aeruginosa from VAP patients in the ICU, supporting its continued use despite nephrotoxicity concerns. The limited activity of CAZ/AVI underscores the need for ongoing local antimicrobial surveillance and strict stewardship practices.
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