Institute of Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Str. 2/E1, 97080 Würzburg, Germany.
Int J Antimicrob Agents. 2012 Mar;39(3):255-8. doi: 10.1016/j.ijantimicag.2011.10.015. Epub 2012 Jan 9.
The aim of this study was to determine the current susceptibility of hospital isolates of contemporary Gram-negative pathogens to the carbapenems doripenem, imipenem and meropenem. Between May and October 2008, seven centres in Germany were invited to collect and submit Pseudomonas aeruginosa, Enterobacteriaceae and other Gram-negative bacterial Intensive Care Unit (ICU)/non-ICU isolates from patients with complicated intra-abdominal infections (cIAIs), bloodstream infections (BSIs) or nosocomial pneumonia (NP). Susceptibility was determined at each centre by Etest. A central laboratory performed species confirmation as well as limited susceptibility and quality control testing. In total, 363 isolates were collected, comprising 46.0% Enterobacteriaceae, 45.2% P. aeruginosa, 4.7% Acinetobacter spp. and 4.1% other Gram-negatives. Most isolates (47.9%) were collected from NP, 32.8% were from cIAIs and 19.3% from BSIs; 57.3% were obtained from ICU patients. The MIC(90) values (minimum inhibitory concentration for 90% of the isolates) for doripenem, meropenem and imipenem were, respectively, 4, 16 and 32 mg/L against P. aeruginosa, 0.06, 0.06 and 0.5mg/L against Enterobacteriaceae and ≥ 64 mg/L for each carbapenem against other Gram-negative isolates. Using European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints, 81.1%, 75.6% and 79.3% of P. aeruginosa were susceptible to doripenem, imipenem and meropenem, respectively. Against all pathogens combined, MIC(90) values for ICU versus non-ICU isolates, respectively, were 4 mg/L vs. 1mg/L for doripenem, 8 mg/L vs. 1mg/L for meropenem and ≥ 64 mg/L vs. 8 mg/L for imipenem. Doripenem showed comparable activity against P. aeruginosa from patients with BSIs, cIAIs or NP. Similar findings were observed for Enterobacteriaceae and other Gram-negatives, including Acinetobacter spp. Doripenem generally showed similar or slightly better activity than meropenem and better activity than imipenem against Gram-negative pathogens collected in Germany.
本研究旨在确定当前耐碳青霉烯类药物的医院分离株对碳青霉烯类药物多利培南、亚胺培南和美罗培南的敏感性。2008 年 5 月至 10 月期间，德国的 7 家中心受邀收集并提交来自复杂性腹腔内感染（cIAI）、血流感染（BSI）或医院获得性肺炎（NP）患者的铜绿假单胞菌、肠杆菌科和其他革兰氏阴性菌 ICU/非 ICU 分离株。各中心通过 Etest 确定敏感性。一个中央实验室进行了种属确认以及有限的敏感性和质量控制测试。共收集 363 株分离株，其中包括 46.0%的肠杆菌科、45.2%的铜绿假单胞菌、4.7%的不动杆菌属和 4.1%的其他革兰氏阴性菌。大多数分离株（47.9%）来自 NP，32.8%来自 cIAI，19.3%来自 BSI；57.3%来自 ICU 患者。多利培南、美罗培南和亚胺培南的 MIC90（对 90%分离株的最小抑菌浓度）值分别为 4、16 和 32mg/L 对铜绿假单胞菌，0.06、0.06 和 0.5mg/L 对肠杆菌科，对其他革兰氏阴性菌每种碳青霉烯类药物的 MIC90 值均≥64mg/L。使用欧洲抗菌药物敏感性试验委员会（EUCAST）折点，81.1%、75.6%和 79.3%的铜绿假单胞菌对多利培南、亚胺培南和美罗培南分别敏感。对所有病原体的综合分析，ICU 与非 ICU 分离株的 MIC90 值分别为 4mg/L 与 1mg/L 对多利培南，8mg/L 与 1mg/L 对美罗培南，≥64mg/L 与 8mg/L 对亚胺培南。多利培南对来自 BSI、cIAI 或 NP 患者的铜绿假单胞菌具有相似的活性。对肠杆菌科和其他革兰氏阴性菌，包括不动杆菌属，也观察到类似的发现。多利培南通常对革兰氏阴性病原体的活性与美罗培南相似或略优，与亚胺培南相比，对革兰氏阴性病原体的活性更强。
