2383. <i>In Vitro</i> Activity of Ceftolozane–Tazobactam in Comparison With Ceftazidime–Avibactam vs. Antimicrobial Non-Susceptible <i>Pseudomonas aeruginosa</i> Clinical Isolates, Including Multidrug-Resistant and Extensively Drug-Resistant Subsets: CANWARD, 2007–2017
Bibliographic record
Abstract
Pseudomonas aeruginosa (PA) is an important nosocomial pathogen. Treatment options for infections caused by multidrug-resistant (MDR) and extensively drug-resistant (XDR) isolates remain limited. Ceftolozane-tazobactam (C/T) and ceftazidime–avibactam (CZA) are two newer antimicrobials with antipseudomonal activity. The purpose of this study was to directly compare the in vitro activity of C/T and CZA vs. antimicrobial non-susceptible (NS) PA clinical isolates obtained as part of the CANWARD study. Annually from 2007 to 2017, sentinel hospitals across Canada submitted blood, respiratory, urine, and wound isolates (consecutive, one per patient/infection site) from patients attending ERs, medical and surgical wards, hospital clinics, and ICUs (CANWARD). Susceptibility testing was performed using broth microdilution (and breakpoints) as described by CLSI. MDR PA were defined as isolates that tested NS to at least one antimicrobial from ≥3 classes. XDR PA were defined as isolates that tested NS to at least one antimicrobial from ≥5 classes. 4224 PA isolates were obtained as a part of CANWARD. 628 (14.9%) were MDR, and 129 (3.1%) were XDR. The in vitro activity of C/T and CZA (plus relevant comparators) is presented below. The in vitro activity of C/T was superior to CZA vs. antimicrobial NS PA clinical isolates (including MDR and XDR isolates) recovered from patients across Canada. D. Hoban, Abbott: Research relationship, Research support. Achaogen: Research relationship, Research support. Astellas: Research relationship, Research support. Merck Canada: Research relationship, Research support. Merck USA: Research relationship, Research support. Paratek Pharma: Research relationship, Research support. Pharmascience: Research relationship, Research support. Sunovion: Research relationship, Research support. Tetraphase: Research relationship, Research support. The Medicines Co.: Reserch relationship, Research support. Zoetis: Research relationship, Research support. G. Zhanel, Achaogen: Research relationship, Research support. Astellas: Research relationship, Research support. Merck Canada: Research relationship, Research support. Merck USA: Research relationship, Research support. Paratek PHarma: Research relationship, Research support. Pharmascience: Research relationship, Research support. Sunovion: Research relationship, Research support. Tetraphase: Research relationship, Research support. The Medicines Co.: Research relationship, Research support. Zoetis: Reserch relationship, Research support.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".