RESUMO
OBJECTIVES: Ceftazidime-avibactam (CAZ-AVI) is an option for infections caused by MDR gram-negative bacilli. In this study, we aimed to analyze the in vitro antimicrobial activity of CAZ-AVI and other antimicrobial agents against gram-negative bacilli that were collected in Colombia between 2019 and 2021 from patients with bacteremia and skin and soft-tissue infections (SSTIs). METHODS: A total of 600 Enterobacterales and 259 P. aeruginosa strains were analyzed. The phenotypic resistance of isolates, particularly non-susceptibility to meropenem, multidrug-resistant (MDR) isolates, and difficult-to-treat (DTR) P. aeruginosa, was evaluated according to CLSI breakpoints. RESULTS: Enterobacterales had the most susceptibility to CAZ-AVI (96.5 %) and tigecycline (95 %). Tigecycline and CAZ-AVI were the antimicrobial agents with the most in vitro activity against carbapenem-resistant Enterobacterales (CRE). CAZ-AVI was the antimicrobial treatment with the most activity against P. aeruginosa. CONCLUSIONS: Tigecycline and CAZ-AVI were the antimicrobial agents with the most activity against CRE and MDR Enterobacterales. For P. aeruginosa, CAZ-AVI was the antimicrobial treatment with the most in vitro activity.
Assuntos
Antibacterianos , Compostos Azabicíclicos , Bacteriemia , Ceftazidima , Combinação de Medicamentos , Bactérias Gram-Negativas , Testes de Sensibilidade Microbiana , Infecções dos Tecidos Moles , Tigeciclina , Humanos , Ceftazidima/farmacologia , Infecções dos Tecidos Moles/microbiologia , Infecções dos Tecidos Moles/tratamento farmacológico , Colômbia , Compostos Azabicíclicos/farmacologia , Antibacterianos/farmacologia , Bacteriemia/microbiologia , Bacteriemia/tratamento farmacológico , Bactérias Gram-Negativas/efeitos dos fármacos , Tigeciclina/farmacologia , Pseudomonas aeruginosa/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Enterobacteriaceae/efeitos dos fármacos , Dermatopatias Bacterianas/microbiologia , Dermatopatias Bacterianas/tratamento farmacológicoRESUMO
La ausencia de evaluaciones de costo-efectividad en esta área hace que el presente estudio se convierta en una base para continuar avanzando en el tema, concluyen los investigadores del presente estudio. La toxoplasmosis congénita es el resultado de la infección fetal transplacentaria por Toxoplasma gondii después de la infección materna primaria durante el periodo de gestación. La gravedad de la enfermedad dependerá de la edad gestacional al momento de la transmisión. Las infecciones en el primer trimestre son más graves, pero menos frecuentes que las infecciones del tercer trimestre. El diagnóstico de la toxoplasmosis es muy complejo, siendo difícil en muchos casos diferenciar entre la infección aguda o activa y la crónica, y se basa principalmente en el uso de métodos indirectos, como los serológicos, aunque también en métodos de detección directa del parásito. En muchos casos, es necesario combinar diferentes métodos para conseguir la adecuada evaluación diagnóstica.
The absence of cost-effectiveness evaluations in this area makes the present study a basis for continuing to advance on the subject, conclude the researchers of the present study. Congenital toxoplasmosis is the result of transplacental fetal Toxoplasma gondii infection after primary maternal infection during the gestation period. The severity of the disease will depend on the gestational age at the time of transmission. First trimester infections are more serious, but less common than third trimester infections. The diagnosis of toxoplasmosis is very complex, being difficult in many cases to differentiate between acute or active infection and chronic infection, and it is based mainly on the use of indirect methods, such as serological, but also on direct detection of the parasite. In many cases, it is necessary to combine different methods to achieve an adequate diagnostic evaluation.
