{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:19:49Z","timestamp":1785935989081,"version":"3.56.0"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"vor","delay-in-days":32,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Merck Sharp & Dohme Corp.,"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To describe the pathogen predominance and to evaluate the probability of covering the most common Gram-negative pathogens collectively in both empirical and early adjustment prescribing scenarios in ICU patients with respiratory infections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data were collected from an international cohort of hospitals as part of the SMART Surveillance Program (2018). Susceptibility testing (mg\/L) was performed by broth microdilution methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>7171 Gram-negative respiratory isolates from adult ICU patients across 209 hospitals from 56 different countries were studied. Overall, the most common ICU respiratory pathogens isolated were Pseudomonas aeruginosa (25%), Klebsiella pneumoniae (18%), Acinetobacter baumannii (14%), and Escherichia coli (11%), with inter-regional differences among these pathogens. Among Enterobacterales, 36% were ESBL positive. When the collective susceptibility profile of this set of pathogens (P. aeruginosa plus Enterobacterales; comprising 78% of all organisms isolated) was performed, ceftolozane\/tazobactam (84%), followed by meropenem (81%), provided the most reliable in vitro activity in the empirical prescribing scenario compared with other \u03b2-lactam antibiotics. P. aeruginosa co-resistance was common among first-line \u03b2-lactam antibiotics. If P. aeruginosa was non-susceptible to piperacillin\/tazobactam, less than one-third were susceptible to meropenem or ceftazidime. In contrast, ceftolozane\/tazobactam offered in vitro coverage in over two-thirds of these resistant pathogens.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Ceftolozane\/tazobactam demonstrated high cumulative susceptibility levels and in vitro activity in both empirical and adjustment antibiotic prescribing scenarios. High frequency of co-resistance undermines reliable coverage for Gram-negative pathogens already resistant to first-line agents. Ceftolozane\/tazobactam would offer additional coverage in this setting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaa129","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T20:13:35Z","timestamp":1612815215000},"source":"Crossref","is-referenced-by-count":17,"title":["Collective assessment of antimicrobial susceptibility among the most common Gram-negative respiratory pathogens driving therapy in the ICU"],"prefix":"10.1093","volume":"3","author":[{"given":"Pamela A","family":"Moise","sequence":"first","affiliation":[{"name":"Merck & Co., Inc, Kenilworth, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"MSD Spain, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Alekseeva","sequence":"additional","affiliation":[{"name":"MSD Dubai, Dubai, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Lopez","sequence":"additional","affiliation":[{"name":"MSD Spain, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brune","family":"Akrich","sequence":"additional","affiliation":[{"name":"MSD France, Puteaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Andrew","family":"DeRyke","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc, Kenilworth, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Ting","family":"Chen","sequence":"additional","affiliation":[{"name":"MSD Taiwan, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Pavia","sequence":"additional","affiliation":[{"name":"MSD Colombia, Bogota, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Palermo","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc, Kenilworth, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Hackel","sequence":"additional","affiliation":[{"name":"IHMA, Schaumburg, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Motyl","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc, Kenilworth, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"key":"2021052710301275600_dlaa129-B1","doi-asserted-by":"crossref","first-page":"1700582","DOI":"10.1183\/13993003.00582-2017","article-title":"International ERS\/ESICM\/ESCMID\/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: Guidelines for the management of hospital-acquired pneumonia (HAP)\/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociaci\u00f3n Latinoamericana del T\u00f3rax (ALAT)","volume":"50","author":"Torres","year":"2017","journal-title":"Eur Respir J"},{"key":"2021052710301275600_dlaa129-B2","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1093\/cid\/ciw353","article-title":"Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society","volume":"63","author":"Kalil","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2021052710301275600_dlaa129-B3","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1186\/s13054-020-03091-2","article-title":"Update of the treatment of nosocomial pneumonia in the 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