{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:57:34Z","timestamp":1783432654834,"version":"3.54.6"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T00:00:00Z","timestamp":1716595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T00:00:00Z","timestamp":1716595200000},"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":["Ann Clin Microbiol Antimicrob"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Aztreonam-avibactam (ATM-AVI) combination shows promising effectiveness on most carbapenemase-producing Gram-negatives, yet standardized antibiotic susceptibility testing (AST) methods for evaluating the combination in clinical laboratories is lacking. We aimed to evaluate different ATM-AVI AST approaches.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>96 characterized carbapenem-resistant clinical isolates belonging to 9 <jats:italic>Enterobacterales<\/jats:italic> (EB; n\u2009=\u200980) and <jats:italic>P. aeruginosa<\/jats:italic> (PA; n\u2009=\u200916) species, including 90 carbapenemase producers and 72 strains resistant to both CAZ-AVI and ATM, were tested. Paper disk elution (DE; Bio-Rad) and E-test gradient strips stacking (SS; bioM\u00e9rieux) were performed for the ATM\u2009+\u2009CAZ-AVI combination. MIC Test Strip (MTS; Liofilchem) was evaluated for ATM-AVI MIC determination. Results were interpreted applying ATM clinical breakpoints of the EUCAST guidelines and compared to the broth microdilution method (Sensititre, Thermofisher).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>According to broth microdilution method, 93% of EB and 69% of PA were tested susceptible to ATM-AVI. The synergistic effect of ATM-AVI was of 95% for EB, but of only 17% for PA. The MTS method yielded higher categorical and essential agreement (CA\/EA) rates for both EB (89%\/91%) and PA (94%\/94%) compared to SS, where the rates were 87%\/83% for EB and 81%\/81% for PA. MTS and SS yielded 2 and 3 major discrepancies, respectively, while 3 very major discrepancies each were observed for both methods. Concerning the DE method, CA reached 91% for EB and 81% for PA, but high number of very major discrepancies were observed for EB (n\u2009=\u20096; 8%) and for PA (n\u2009=\u20093; 19%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The ATM-AVI association displayed excellent in vitro activity against highly resistant clinical <jats:italic>Enterobacterales<\/jats:italic> strains. MTS method offers accurate ATM-AVI AST results, while the SS method might serve as better alternative then DE method in assessing the efficacy of ATM\u2009+\u2009CAZ-AVI combination. However, further investigation is needed to confirm the methods' ability to detect ATM-AVI resistance.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12941-024-00708-0","type":"journal-article","created":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T06:02:04Z","timestamp":1716616924000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of testing methods assessing the in vitro efficacy of the combination of aztreonam with avibactam on multidrug-resistant Gram-negative bacilli"],"prefix":"10.1186","volume":"23","author":[{"given":"Corentin","family":"Deckers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"B\u00e9lik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Denis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Bogaerts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Montesinos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Berhin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warda","family":"Bouchahrouf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hoebeke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Evrard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Gilliard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"Okur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Te-Din","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,25]]},"reference":[{"key":"708_CR1","unstructured":"Efficacy, Safety, and Tolerability of ATM-AVI in the Treatment of Serious Infection Due to MBL-producing Gram-negative Bacteria. ClinicalTrials.gov ID NCT03580044."},{"key":"708_CR2","unstructured":"A Study to Determine the Efficacy, Safety and Tolerability of Aztreonam-Avibactam (ATM-AVI) \u00b1 Metronidazole (MTZ) Versus Meropenem (MER) \u00b1 Colistin (COL) for the Treatment of Serious Infections Due to Gram Negative Bacteria. (REVISIT). ClinicalTrials.gov ID NCT03329092."},{"issue":"11","key":"708_CR3","doi-asserted-by":"publisher","first-page":"1871","DOI":"10.1093\/cid\/ciaa586","volume":"72","author":"M Falcone","year":"2021","unstructured":"Falcone M, et al. Efficacy of ceftazidime-avibactam plus Aztreonam in patients with bloodstream infections caused by metallo-beta-lactamase-producing Enterobacterales. Clin Infect Dis. 2021;72(11):1871\u20138.","journal-title":"Clin Infect Dis"},{"key":"708_CR4","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02243-16","author":"S Marshall","year":"2017","unstructured":"Marshall S, et al. Can ceftazidime-avibactam and aztreonam overcome beta-lactam resistance conferred by metallo-beta-lactamases in Enterobacteriaceae? Antimicrob Agents Chemother. 2017. https:\/\/doi.org\/10.1128\/AAC.02243-16.","journal-title":"Antimicrob Agents Chemother"},{"issue":"8","key":"708_CR5","doi-asserted-by":"publisher","first-page":"e0048621","DOI":"10.1128\/AAC.00486-21","volume":"65","author":"A Bhatnagar","year":"2021","unstructured":"Bhatnagar A, et al. Aztreonam-avibactam susceptibility testing program for metallo-beta-lactamase-producing Enterobacterales in the antibiotic resistance laboratory network, march 2019 to December 2020. Antimicrob Agents Chemother. 2021;65(8):e0048621.","journal-title":"Antimicrob Agents Chemother"},{"key":"708_CR6","doi-asserted-by":"publisher","first-page":"7107","DOI":"10.2147\/IDR.S385240","volume":"15","author":"G Lu","year":"2022","unstructured":"Lu G, et al. In vitro and in vivo antimicrobial activities of ceftazidime\/avibactam alone or in combination with Aztreonam against carbapenem-resistant Enterobacterales. Infect Drug Resist. 2022;15:7107\u201316.","journal-title":"Infect Drug Resist"},{"issue":"8","key":"708_CR7","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1038\/s41429-022-00537-3","volume":"75","author":"P Sreenivasan","year":"2022","unstructured":"Sreenivasan P, et al. In-vitro susceptibility testing methods for the combination of ceftazidime-avibactam with aztreonam in metallobeta-lactamase producing organisms: role of combination drugs in antibiotic resistance era. J Antibiot. 2022;75(8):454\u201362.","journal-title":"J Antibiot"},{"key":"708_CR8","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01426-19","author":"M Biagi","year":"2019","unstructured":"Biagi M, et al. Searching for the optimal treatment for metallo- and serine-beta-lactamase producing Enterobacteriaceae: aztreonam in combination with ceftazidime-avibactam or meropenem-vaborbactam. Antimicrob Agents Chemother. 2019. https:\/\/doi.org\/10.1128\/AAC.01426-19.","journal-title":"Antimicrob Agents Chemother"},{"key":"708_CR9","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1249030","author":"AT Aslan","year":"2023","unstructured":"Aslan AT, et al. In vitro, in vivo and clinical studies comparing the efficacy of ceftazidime-avibactam monotherapy with ceftazidime-avibactam-containing combination regimens against carbapenem-resistant Enterobacterales and multidrug-resistant Pseudomonas aeruginosa isolates or infections: a scoping review. Front Med. 2023. https:\/\/doi.org\/10.3389\/fmed.2023.1249030.","journal-title":"Front Med"},{"issue":"4","key":"708_CR10","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1016\/j.cmi.2021.11.025","volume":"28","author":"M Paul","year":"2022","unstructured":"Paul M, et al. European society of clinical microbiology and infectious diseases (ESCMID) guidelines for the treatment of infections caused by multidrug-resistant Gram-negative bacilli (endorsed by European society of intensive care medicine). Clin Microbiol Infect. 2022;28(4):521\u201347.","journal-title":"Clin Microbiol Infect"},{"issue":"11","key":"708_CR11","doi-asserted-by":"publisher","first-page":"e0084621","DOI":"10.1128\/AAC.00846-21","volume":"65","author":"A Khan","year":"2021","unstructured":"Khan A, et al. Evaluation of susceptibility testing methods for aztreonam and ceftazidime-avibactam combination therapy on extensively drug-resistant gram-negative organisms. Antimicrob Agents Chemother. 2021;65(11):e0084621.","journal-title":"Antimicrob Agents Chemother"},{"key":"708_CR12","unstructured":"The European Committee on Antimicrobial Susceptibility Testing, Breakpoint tables for interpretation of MICs and zone diameters. Version 13.1. 2023. http:\/\/www.eucast.org."},{"key":"708_CR13","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10081012","author":"C Mauri","year":"2021","unstructured":"Mauri C, et al. The revival of aztreonam in combination with avibactam against metallo-beta-lactamase-producing gram-negatives: a systematic review of in vitro studies and clinical cases. Antibiotics. 2021. https:\/\/doi.org\/10.3390\/antibiotics10081012.","journal-title":"Antibiotics"},{"key":"708_CR14","doi-asserted-by":"publisher","unstructured":"Cardot ME. et al. Evaluation of the MTS aztreonam-avibactam strip (Liofilchem) on New Delhi metallo-beta-lactamase-producing Enterobacterales. Eur J Clin Microbiol Infect Dis. 2024. https:\/\/doi.org\/10.1007\/s10096-024-04766-2","DOI":"10.1007\/s10096-024-04766-2"},{"key":"708_CR15","volume-title":"Microbiological surveillance of carbapenemase-producing Enterobacterales (CPE) in Belgium","author":"T-D Huang","year":"2023","unstructured":"Huang T-D, Montesinos I, Evrard S, Berhin C, Bouchahrouf W, Hoebeke M, Wallemme I, Denis O. Microbiological surveillance of carbapenemase-producing Enterobacterales (CPE) in Belgium. Basel: ECCMID; 2023."},{"key":"708_CR16","doi-asserted-by":"publisher","first-page":"1224922","DOI":"10.3389\/fmed.2023.1224922","volume":"10","author":"Y Merad","year":"2023","unstructured":"Merad Y, et al. Case report: continuous infusions of ceftazidime-avibactam and aztreonam in combination through elastomeric infusors for 12 weeks for the treatment of bone and joint infections due to metallo-beta-lactamase producing Enterobacterales. 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Antimicrob Agents Chemother. 2019. https:\/\/doi.org\/10.1128\/AAC.00010-19.","journal-title":"Antimicrob Agents Chemother"},{"issue":"1","key":"708_CR19","doi-asserted-by":"publisher","first-page":"115227","DOI":"10.1016\/j.diagmicrobio.2020.115227","volume":"99","author":"M Lee","year":"2021","unstructured":"Lee M, Abbey T, Biagi M, Wenzler E. Activity of aztreonam in combination with ceftazidime-avibactam against serine- and metallo-beta-lactamase-producing Pseudomonas aeruginosa. Diagn Microbiol Infect Dis. 2021;99(1):115227.","journal-title":"Diagn Microbiol Infect Dis"},{"key":"708_CR20","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00472-17","author":"JA Karlowsky","year":"2017","unstructured":"Karlowsky JA, et al. In Vitro activity of aztreonam-avibactam against Enterobacteriaceae and pseudomonas aeruginosa isolated by clinical laboratories in 40 countries from 2012 to 2015. Antimicrob Agents Chemother. 2017. https:\/\/doi.org\/10.1128\/AAC.00472-17.","journal-title":"Antimicrob Agents Chemother"},{"key":"708_CR21","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01659-20","author":"M Sadek","year":"2020","unstructured":"Sadek M, Juhas M, Poirel L, Nordmann P. Genetic features leading to reduced susceptibility to aztreonam-avibactam among metallo-beta-lactamase-producing escherichia coli isolates. Antimicrob Agents Chemother. 2020. https:\/\/doi.org\/10.1128\/AAC.01659-20.","journal-title":"Antimicrob Agents Chemother"},{"key":"708_CR22","doi-asserted-by":"publisher","first-page":"1322180","DOI":"10.3389\/fmicb.2023.1322180","volume":"14","author":"G Verschelden","year":"2023","unstructured":"Verschelden G, et al. Aztreonam-avibactam synergy, a validation and comparison of diagnostic tools. Front Microbiol. 2023;14:1322180.","journal-title":"Front Microbiol"},{"key":"708_CR23","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkad407","author":"M Deschamps","year":"2023","unstructured":"Deschamps M, Dauwalder O, Dortet L. Comparison of ETEST(R) superposition method and the MTS Aztreonam-avibactam strip with the reference method for aztreonam\/avibactam susceptibility testing. J Antimicrob Chemother. 2023. https:\/\/doi.org\/10.1093\/jac\/dkad407.","journal-title":"J Antimicrob Chemother"},{"key":"708_CR24","doi-asserted-by":"publisher","first-page":"3563","DOI":"10.2147\/IDR.S273989","volume":"13","author":"C Zou","year":"2020","unstructured":"Zou C, et al. In vitro activity of ceftazidime-avibactam and aztreonam-avibactam against carbapenem-resistant Enterobacteriaceae isolates collected from three secondary hospitals in southwest china between 2018 and 2019. Infect Drug Resist. 2020;13:3563\u20138.","journal-title":"Infect Drug Resist"},{"key":"708_CR25","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.ijid.2020.05.075","volume":"97","author":"B Zhang","year":"2020","unstructured":"Zhang B, et al. In vitro activity of aztreonam-avibactam against metallo-beta-lactamase-producing Enterobacteriaceae-A multicenter study in China. Int J Infect Dis. 2020;97:11\u20138.","journal-title":"Int J Infect Dis"}],"container-title":["Annals of Clinical Microbiology and Antimicrobials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12941-024-00708-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12941-024-00708-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12941-024-00708-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T06:02:10Z","timestamp":1716616930000},"score":1,"resource":{"primary":{"URL":"https:\/\/ann-clinmicrob.biomedcentral.com\/articles\/10.1186\/s12941-024-00708-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,25]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["708"],"URL":"https:\/\/doi.org\/10.1186\/s12941-024-00708-0","relation":{},"ISSN":["1476-0711"],"issn-type":[{"value":"1476-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,25]]},"assertion":[{"value":"29 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"47"}}