Susceptibilidade de Pseudomonas aeruginosa à nova combinação de beta-lactâmico com inibidor de beta-lactamase, Ceftolozane-tazobactam

Abstract

Pseudomonas aeruginosa is frequently associated with serious infections, affecting mainly hospitalized patients. Often, these microorganisms have a multiresistant profile, including resistance to carbapenems, generating about 35 and 33 thousand deaths yearly in the United States and Europe, respectively. Ceftolozane-tazobactam is the combination of a new beta-lactam with a beta-lactamase inhibitor, developed for the treatment of serious infections caused by P. aeruginosa. The purpose of this descriptive review is to compile information available in current scientific literature regarding the susceptibility and resistance mechanisms to ceftolozane-tazobactam in Brazil and worldwide. The overall susceptibility of P. aeruginosa is > 90%, except in cases of multidrug resistance, being reduced to 72.5-88%. In Brazil, epidemiological data of susceptibility to ceftolozane-tazobactam are still insufficient and stratified. Despite the limited time of clinical use, P. aeruginosa resistant to ceftolozane-tazobactam have been isolated globally. AmpC overexpression and mutations are the main resistance mechanisms reported, directly influencing and increasing MIC values. Resistance reported to this compound is worrying and reinforces the importance of systematic surveillance concerning prevalence of resistance and its mechanisms developed by P. aeruginosa.