There is a need to distinguish novel treatment techniques for this ( Stenotrophomonas maltophilia) microorganism, particularly against disconnects impervious to first-line specialists. Aztreonam in combination with avibactam has demonstrated potential, although data on other aztreonam–β-lactamase inhibitor (BLI) combinations are lacking. The primary aim of this research was to study, evaluate and compare the in vitro activities and to understand the mechanisms of resistance to Aztreonam in Combination with Avibactam, Clavulanate, Relebactam, and Vaborbactam against Multidrug-Resistant Stenotrophomonas maltophilia. A panel of 47 clinical S. maltophilia strains nonsusceptible to levofloxacin and/or trimethoprim-sulfamethoxazole were tested against each aztreonam-BLI combination. Three isolates with various aztreonam-BLI MICs were subjected to whole-genome sequencing and quantitative reverse transcriptase PCR. As a result it was found that, Avibactam restored aztreonam susceptibility in 98% of aztreonam-resistant isolates, compared to 61, 71, and 15% with clavulanate, relebactam, and vaborbactam, respectively. Decreased susceptibility may be due to the combination of overexpressed β-lactamases and efflux pumps. Therefore, as a conclusion we can say that, Aztreonam-avibactam is the most promising BLI-combination against multidrug-resistant S. maltophilia.
Reference link- https://aac.asm.org/content/64/12/e00297-20
