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Original Article
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Epidemiology and in vitro activity of ceftazidime-
avibactam and comparator agents against multidrug-
resistant isolates of Enterobacterales and
Pseudomonas
aeruginosa
collected in Latin America as part of the ATLAS
surveillance program in 2015
2020
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Mark G. Wise
a
,
*
, James A. Karlowsky
a
,
b
, Elkin V. Lemos-Luengas
c
,
Rafael R. Valdez
d
, Daniel F. Sahm
a
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a
IHMA, Schaumburg, IL, USA
b
Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba,
Winnipeg, Canada
c
P
fi
zer Medical Scienti
fi
c Expert for LATAM, Bogota, Colombia
d
P
fi
zer Hospital Regional Director for LATAM, Mexico City, Mexico
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ARTICLE INFO
Article history:
Received 7 November 2022
Accepted 13 March 2023
Available online 25 March 2023
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ABSTRACT
Introduction:
The incidence of antimicrobial resistance is increasing in many parts of the
world. The focus of this report is to examine changes in antimicrobial resistance epidemiol-
ogy among clinical isolates of Enterobacterales and
Pseudomonas aeruginosa
collected in six
Latin American countries as part of the Antimicrobial Testing Leadership and Surveillance
(ATLAS) program from 2015 to 2020, with a focus on the in vitro activity of ceftazidime-avi-
bactam against Multidrug-Resistant (MDR) isolates.
Methods:
Non-duplicate, clinical isolates of Enterobacterales (
n
= 15,215) and
P. aeruginosa
(
n
= 4,614) collected by 40 laboratories in Argentina, Brazil, Chile, Colombia, Mexico, and
Venezuela, from 2015 to 2020, underwent centralized Clinical Lab Standards Institute (CLSI)
broth microdilution susceptibility testing. Minimum Inhibitory Concentration (MIC) values
were interpreted using 2022 CLSI breakpoints. An MDR phenotype was de
fi
ned by resis-
tance to
3 of seven sentinel agents.
Results:
In total, 23.3% of Enterobacterales and 25.1% of
P. aeruginosa
isolates were MDR.
Annual percent MDR values for Enterobacterales were stable from 2015 to 2018
(21.3% to 23.7% year) but markedly increased in 2019 (31.5%) and 2020 (32.4%).
Annual
percent MDR values for
P.
aeruginosa
were stable from 2015 to 2020
(23.0% to 27.6% year). Isolates were divided into two 3-year time-periods, 2015
2017
and 2018
2020, for additional analyses. For Ente
robacterales, 99.3% of all isolates and
97.1% of MDR isolates from 2015
2017 were ceftazidime-avibactam-susceptible com-
pared to 97.2% and 89.3% of isolates, respectively, from 2018
2020. For
P. aeruginosa
,
86.6% of all isolates and 53.9% of MDR isolates from 2015
2017 were ceftazidime-
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Keywords:
Latin America
Enterobacterales
Pseudomonas aeruginosa
Ceftazidime-avibactam
Multidrug-resistant
Surveillance
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* Corresponding author.
E-mail address:
mwise@ihma.com
(M.G. Wise).
https://doi.org/10.1016/j.bjid.2023.102759
1413-8670/
Ó
2023 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-
NC-ND license (
http://creativecommons.org/licenses/by-nc-nd/4.0/
)
braz j infect dis.
2023;
27(3)
:102759
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The Brazilian Journal of
INFECTIOUS DISEASES
www.elsevier.com/locate/bjid
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