In vitro evaluation of meropenem-vaborbactam against clinical CRE isolates at a tertiary care center with low KPC-mediated carbapenem resistance

• Published in: Diagnostic microbiology and infectious disease Vol. 93; no. 3; pp. 258 - 260
• Main Authors: Kinn, Patrick M., Chen, Derrick J., Gihring, Thomas M., Schulz, Lucas T., Fox, Barry C., McCreary, Erin K., Lepak, Alexander J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2019
• Subjects: Anti-Bacterial Agents - pharmacology; Antimicrobial stewardship; Bacterial Proteins - metabolism; beta-Lactamase Inhibitors - pharmacology; beta-Lactamases - metabolism; Boronic Acids - pharmacology; Carbapenem-Resistant Enterobacteriaceae - drug effects; Carbapenem-Resistant Enterobacteriaceae - enzymology; Carbapenem-Resistant Enterobacteriaceae - isolation & purification; CRE; Drug Combinations; Drug Resistance, Bacterial - drug effects; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Humans; KPC; Meropenem - pharmacology; Meropenem-vaborbactam; Microbial Sensitivity Tests; Tertiary Care Centers; Wisconsin - epidemiology; Wisconsin; Meropenem-vaborbactam; Antimicrobial stewardship; CRE; KPC
• ISSN: 0732-8893; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2018.09.017

The in vitro activity of meropenem-vaborbactam was examined against clinical carbapenem-resistant Enterobacteriaceae isolates collected over 3 years at our medical center. Only 3 KPC-producers were identified. Susceptibility to meropenem-vaborbactam was noted in 15/16 (94%) isolates (MIC90 2 mg/L) that were nonsusceptible to meropenem. Meropenem-vaborbactam may have utility at centers where non–KPC-producers are more frequent. •Meropenem-vaborbactam is a novel drug combination that is particularly potent against KPC-producing CRE.•Meropenem-vaborbactam susceptibility testing by gradient diffusion and disk diffusion was evaluated against 44 clinical CRE isolates from patients at our health care center collected over a 3-year period.•Meropenem-vaborbactam susceptibility testing results were congruent using CLSI-approved gradient diffusion and disk diffusion testing methods.•Meropenem-vaborbactam had relatively potent in vitro activity (MIC90 2 mg/L) against CRE isolates at our center despite a very low incidence of KPC-producing CRE.•Individual health care centers should evaluate novel drugs in the context of the local epidemiology of circulating strains at their center.