{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T16:34:47Z","timestamp":1778949287858,"version":"3.51.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>This antimicrobial surveillance study reports in vitro antimicrobial activity and susceptibility data for a panel of agents against respiratory isolates of <jats:italic>Enterobacterales<\/jats:italic> and <jats:italic>Pseudomonas aeruginosa<\/jats:italic>.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Isolates from respiratory specimens were collected in Africa\/Middle East, Asia\/South Pacific, Europe and Latin America between 2016 and 2018, as part of the Antimicrobial Testing Leadership and Surveillance (ATLAS) program. Broth microdilution methodology was used to quantify minimum inhibitory concentrations, from which rates of susceptibility were determined using EUCAST breakpoints (version 10). Rates of subsets with genes encoding \u03b2-lactamases (extended-spectrum \u03b2-lactamases [ESBLs], serine carbapenemases and metallo-\u03b2-lactamases [MBLs]) were also determined, as well as rates of multidrug-resistant (MDR) <jats:italic>P. aeruginosa<\/jats:italic>.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among all respiratory <jats:italic>Enterobacterales<\/jats:italic> isolates, susceptibility to ceftazidime-avibactam, meropenem, colistin and amikacin was \u226594.4% in each region. For <jats:italic>Enterobacterales<\/jats:italic> isolates that were ESBL-positive or carbapenemase-positive\/MBL-negative, ceftazidime-avibactam susceptibility was 93.6 and 98.9%, respectively. Fewer than 42.7% of MBL-positive <jats:italic>Enterobacterales<\/jats:italic> isolates were susceptible to any agents, except colistin (89.0% susceptible). Tigecycline susceptibility was \u226590.0% among <jats:italic>Citrobacter koseri<\/jats:italic> and <jats:italic>Escherichia coli<\/jats:italic> isolates, including all \u03b2-lactamase-positive subsets. ESBL-positive <jats:italic>Enterobacterales<\/jats:italic> were more commonly identified in each region than isolates that were ESBL\/carbapenemase-positive; carbapenemase-positive\/MBL-negative; or MBL-positive. Among all respiratory <jats:italic>P. aeruginosa<\/jats:italic> isolates, the combined susceptibility rates (susceptible at standard dosing regimen plus susceptible at increased exposure) were highest to ceftazidime-avibactam, colistin and amikacin (\u226582.4% in each region). Susceptibility to colistin was \u226598.1% for all \u03b2-lactamase-positive subsets of <jats:italic>P. aeruginosa<\/jats:italic>. The lowest rates of antimicrobial susceptibility were observed among MBL-positive isolates of <jats:italic>P. aeruginosa<\/jats:italic> (\u226456.6%), with the exception of colistin (100% susceptible). MDR <jats:italic>P. aeruginosa<\/jats:italic> were most frequently identified in each region (18.7\u201328.7%), compared with the subsets of ESBL-positive; carbapenemase-positive\/MBL-negative; or MBL-positive isolates.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Rates of susceptibility among the collections of respiratory <jats:italic>Enterobacterales<\/jats:italic> and <jats:italic>P. aeruginosa<\/jats:italic> isolates were highest to ceftazidime-avibactam, colistin and amikacin in each region. Tigecycline was active against all subsets of <jats:italic>C. koseri<\/jats:italic> and <jats:italic>E. coli<\/jats:italic>, and colistin was active against all subsets of <jats:italic>P. aeruginosa<\/jats:italic>. The findings of this study indicate the need for continued antimicrobial surveillance among respiratory Gram-negative pathogens, in particular those with genes encoding MBLs.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06153-0","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T13:03:54Z","timestamp":1624453434000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["In vitro antimicrobial susceptibility of clinical respiratory isolates to ceftazidime-avibactam and comparators (2016\u20132018)"],"prefix":"10.1186","volume":"21","author":[{"given":"D.","family":"Pi\u00e9rard","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. 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Past and present perspectives on \u03b2-lactamases. Antimicrob Agents Chemother. 2018;62(10). https:\/\/doi.org\/10.1128\/AAC.01076-18.","DOI":"10.1128\/AAC.01076-18"},{"issue":"2","key":"6153_CR4","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1007\/s40265-013-0013-7","volume":"73","author":"GG Zhanel","year":"2013","unstructured":"Zhanel GG, Lawson CD, Adam H, Schweizer F, Zelenitsky S, Lagac\u00e9-Wiens PR, et al. Ceftazidime-avibactam: a novel cephalosporin\/\u03b2-lactamase inhibitor combination. Drugs. 2013;73(2):159\u201377. https:\/\/doi.org\/10.1007\/s40265-013-0013-7.","journal-title":"Drugs"},{"key":"6153_CR5","doi-asserted-by":"publisher","unstructured":"Lagac\u00e9-Wiens P, Walkty A, Karlowsky JA. Ceftazidime-avibactam: an evidence-based review of its pharmacology and potential use in the treatment of gram-negative bacterial infections. 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