Author ORCID Identifier

https://orcid.org/0000-0003-4247-3546

Year of Publication

2020

Degree Name

Master of Science (MS)

Document Type

Master's Thesis

College

Pharmacy

Department

Pharmaceutical Sciences

First Advisor

Dr. David Burgess

Abstract

Pseudomonas aeruginosa causes severe healthcare-associated infections. Forty-eight extensively drug-resistant (XDR)-P. aeruginosa isolates were selected from 287 isolates collected for evaluation based on clinical susceptibility data. In vitro activity of commonly utilized antimicrobials (i.e. antipseudomonal beta-lactams, aminoglycosides, fluoroquinolones, and polymyxins) plus ceftolozane-tazobactam, ceftazidime-avibactam, and aztreonam-avibactam against XDR-P. aeruginosa were determined. The mechanism of resistance profile was determined through phenotypic expression analysis. Overall, polymyxin B and colistin were 100% susceptible. Apart from the polymyxins, ceftolozane-tazobactam had the highest susceptibility (94%) followed by ceftazidime-avibactam (90%) and amikacin (83%). Ceftolozane-tazobactam activity was not significantly different from ceftazidime-avibactam (p=0.6831). Only 40% of isolates were susceptible to aztreonam-avibactam. All other agents demonstrated P. aeruginosa at our institution, in vitro analysis proposes superiority of ceftolozane-tazobactam; however, until further in vitro and in vivo validation both agents are reasonable options.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2020.237

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