IJAA Editor's Choice May

Read both Editor's Choice articles for free in the International Journal of Antimicrobial Chemotherapy.

Outbreak of Candida auris in Spain: A comparison of antifungal activity by three methods with published data


"In this study, Ruiz-Gaitan et al. have tested 8 antifungal drugs against Candida auris, an emerging pathogen causing candidemia outbreaks for which the antifungal resistance phenotype is not well-known. They performed MICs on 73 C. auris isolates belonging to a new clade isolated during a local outbreak in Spain by three different methods including two commercial methods (Sensititre YestOne® and MIC Test Strip) and the reference EUCAST method. Results showed a high resistance rate to fluconazole (100%) and to voriconazole (60%). However, a poor correlation between the methods was observed for voriconazole. Isolates remain susceptible to amphotericin B and echinocandin. Overall, the Sensititre method seemed more correlated with the EUCAST reference method (>93% agreement).


MICs determinations on different clades of C. auris are still needed to establish epidemiological cut off values (ECVs) as it seems species and method dependent. Moreover, this study demonstrates that C. auris is an emerging pathogen throughout the world that may cause outbreak in specific settings for which reservoir and source are not well understood so far."

Non-Carbapenem Antibiotics to Treat Severe Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae Infections in Intensive Care Unit Patients


"The purpose of this study was to evaluate the clinical outcome of administrating non carbapenem antibiotics in patients hospitalized in ICU with a severe ESBL-producing Enterobacteriaceae infection. This retrospective multicenter cohort study included a group of patients treated with non-carbapenem antibiotics that was compared to a group of patients treated with carbapenems antibiotics between 2016 and 2017. The primary outcome was treatment failure at 30 days (including recurrence of death). Non-carbapenem antibiotics included piperacillin-tazobactam (60%), ceftazidime-avibactam (18%), temocillin (7%), cefepime (5%) and ciprofloxacin (10%). Results showed no significant differences in the outcomes and in infection-recurrence between the two groups. This retrospective study gives interesting information about the clinical efficacy and outcomes of patients treated with these non-carbapenems antibiotics. Carbapenem antibiotics are last resort antibiotics but an increase resistance rate has been reported worldwide. Several non-carbapenem antibiotics have been suggested to replace the use of carbapenem but literature often showed conflicting results and a lack of PK/PD knowledge for some old antibiotics. These results may be considered for the re-evaluation of recommendations for the empirical treatment of severe Enterobacterial infections in ICU and may thus limit the use of carbapenems."

 

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