Comparative Activity of Carbapenem Testing (COMPACT) study in Germany.
The aim of this study was to determine the current susceptibility of hospital isolates of contemporary Gram-negative pathogens to the carbapenems doripenem, imipenem and meropenem. Between May and October 2008, seven centres in Germany were invited to collect and submit Pseudomonas aeruginosa, Enterobacteriaceae and other Gram-negative bacterial Intensive Care Unit (ICU)/non-ICU isolates from patients with complicated intra-abdominal infections (cIAIs), bloodstream infections (BSIs) or nosocomial pneumonia (NP). Susceptibility was determined at each centre by Etest. A central laboratory performed species confirmation as well as limited susceptibility and quality control testing. In total, 363 isolates were collected, comprising 46.0% Enterobacteriaceae, 45.2% P. aeruginosa, 4.7% Acinetobacter spp. and 4.1% other Gram-negatives. Most isolates (47.9%) were collected from NP, 32.8% were from cIAIs and 19.3% from BSIs; 57.3% were obtained from ICU patients. The MIC(90) values (minimum inhibitory concentration for 90% of the isolates) for doripenem, meropenem and imipenem were, respectively, 4, 16 and 32 mg/L against P. aeruginosa, 0.06, 0.06 and 0.5mg/L against Enterobacteriaceae and ≥ 64 mg/L for each carbapenem against other Gram-negative isolates. Using European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints, 81.1%, 75.6% and 79.3% of P. aeruginosa were susceptible to doripenem, imipenem and meropenem, respectively. Against all pathogens combined, MIC(90) values for ICU versus non-ICU isolates, respectively, were 4 mg/L vs. 1mg/L for doripenem, 8 mg/L vs. 1mg/L for meropenem and ≥ 64 mg/L vs. 8 mg/L for imipenem. Doripenem showed comparable activity against P. aeruginosa from patients with BSIs, cIAIs or NP. Similar findings were observed for Enterobacteriaceae and other Gram-negatives, including Acinetobacter spp. Doripenem generally showed similar or slightly better activity than meropenem and better activity than imipenem against Gram-negative pathogens collected in Germany.
Institute of Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Str. 2/E1, 97080 Würzburg, Germany. valenza@ymail.com
Giuseppe
G
Valenza
Harald
H
Seifert
Sabine
S
Decker-Burgard
Joerg
J
Laeuffer
Ian
I
Morrissey
Reinier
R
Mutters
D016470:Bacteremia / Q000382:microbiology; D015780:Carbapenems / Q000494:pharmacology*; D003428:Cross Infection / Q000382:microbiology; D000077726:Doripenem; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D004756:Enterobacteriaceae Infections / Q000382:microbiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015378:Imipenem / Q000494:pharmacology*; D007362:Intensive Care Units; D059413:Intraabdominal Infections / Q000382:microbiology; D000077731:Meropenem; D008826:Microbial Sensitivity Tests; D011552:Pseudomonas Infections / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D011786:Quality Control; D013845:Thienamycins / Q000494:pharmacology*
D015780:Carbapenems; D013845:Thienamycins; D015378:Imipenem; D000077726:Doripenem; D000077731:Meropenem