2. Academic Validation
  3. In vitro activity of cefepime-zidebactam, ceftolozane-tazobactam, ceftazidime-avibactam, imipenem-relebactam, and other comparators against imipenem-non-susceptible Pseudomonas aeruginosa in Taiwan, 2022

In vitro activity of cefepime-zidebactam, ceftolozane-tazobactam, ceftazidime-avibactam, imipenem-relebactam, and other comparators against imipenem-non-susceptible Pseudomonas aeruginosa in Taiwan, 2022

  • Int J Antimicrob Agents. 2025 Sep;66(3):107550. doi: 10.1016/j.ijantimicag.2025.107550.
Yu-Lin Lee 1,  Mei-Chen Tan 2,  Pei-Jing Chen 2,  Yih-Ru Shiau 2,  Hui-Ying Wang 2,  Jui-Fen Lai 2,  I-Wen Huang 2,  Ya-Sung Yang 3,  Shu-Chen Kuo 4
Affiliations

Affiliations

  • 1 Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; PhD Program in Medical Biotechnology, Institute of Genomics and Bioinformatics, National Chung-Hsing University, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
  • 2 National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan.
  • 3 Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.; Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan. Electronic address: ysyoung4097@gmail.com.
  • 4 National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan. Electronic address: sckuo@nhri.edu.tw.
PMID: 40480535 DOI: 10.1016/j.ijantimicag.2025.107550
Abstract

Objectives: The global expansion of antimicrobial-resistant Pseudomonas aeruginosa, particularly imipenem-non-susceptible (INS) strains poses a formidable health threat. The COVID-19 pandemic has exacerbated antimicrobial resistance trends. We compared the pre- and post-pandemic Antibiotic resistance patterns of INS-P. aeruginosa in Taiwan.

Methods: We analysed 503 P. aeruginosa isolates collected through the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program during 2022. Minimum inhibitory concentrations of various Antibiotics were determined by using broth microdilution. Carbapenemase-encoding genes were identified via multiplex PCR. Antimicrobial resistance trends were compared with data from 2018.

Results: INS-P. aeruginosa comprised 16.9% (85/503) of isolates and exhibited high-level multi-drug resistance. Novel β-lactam-β-lactamase inhibitor combinations (BL-BLIs) demonstrated the highest activity, with 89.4% of INS isolates remaining susceptible to cefepime-zidebactam. However, the susceptibility rates of INS-P. aeruginosa isolates to Other BL-BLIs and comparators declined between 2018 and 2022. Specifically, susceptibility to ceftazidime-avibactam and imipenem-relebactam declined significantly from 81.5% and 85.2% in 2018 to 64.7% and 63.5% in 2022, respectively (both P < 0.05). Additionally, only 70.6% of isolates obtained during 2022 were susceptible to ceftolozane-tazobactam. Carbapenemase genes were detected in 10.6% of isolates, with a notable increase in blaKPC and blaIMP prevalence compared to pre-pandemic data.

Conclusion: The COVID-19 pandemic intensified resistance trends in INS-P. aeruginosa in Taiwan, with increasing prevalence and diversity of carbapenemase-encoding genes. Continuous monitoring and expanded research are essential to combat evolving resistance patterns.

Keywords

Carbapenem-resistant; Pseudomonas aeruginosa; TSAR Surveillance; β-lactam-β-lactamase inhibitor combination.

Figures
Products