Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
J Antimicrob Chemother. 2012 Jun;67(6):1413-21. doi: 10.1093/jac/dks042. Epub 2012 Feb 17.
To investigate the in vitro susceptibility of ertapenem-non-susceptible Enterobacteriaceae (ENSE) isolates to cefotaxime, ceftazidime, cefepime and aztreonam.
Clinical isolates of ENSE tested in this study were obtained from 10 major teaching hospitals in Taiwan during the period January 2008 to October 2010. MICs of ertapenem, cefotaxime, ceftazidime, cefepime and aztreonam were determined by the agar dilution method and were interpreted based on 2011 MIC interpretive criteria recommended by the CLSI and EUCAST.
A total of 412 non-duplicate ENSE isolates (with ertapenem MIC values ≥ 0.5 mg/L) were tested. These comprised 72 isolates of Escherichia coli [28 (38.9%) were extended-spectrum β-lactamase (ESBL)-producing isolates], 167 isolates of Klebsiella pneumoniae [74 (44.3%) were ESBL-producing isolates], 115 isolates of Enterobacter cloacae, 13 isolates of Enterobacter aerogenes, 20 isolates of Citrobacter freundii and 25 isolates of Serratia marcescens. According to 2011 CLSI (EUCAST) MIC interpretive breakpoints for Enterobacteriaceae, 64% (31%) of all ENSE isolates, 45.8% (16.7%) of E. coli isolates, 53% (29.3%) of K. pneumoniae isolates and 86.1% (35.7%) of E. cloacae isolates were susceptible to cefepime. As for ESBL-producing ENSE isolates, 25% and 14.3% of E. coli isolates and 36.5% and 10.8% of K. pneumoniae isolates were susceptible to cefepime based on CLSI and EUCAST criteria, respectively.
Cefepime exerts in vitro antimicrobial activity against a significant portion of clinical isolates of ENSE, although there are discrepancies between results obtained using the CLSI-2011 and EUCAST-2011 guidelines.
研究厄他培南不敏感肠杆菌科（ENSE）分离株对头孢噻肟、头孢他啶、头孢吡肟和氨曲南的体外药敏情况。
本研究中的 ENSE 临床分离株来自台湾 10 家主要教学医院，采集时间为 2008 年 1 月至 2010 年 10 月。采用琼脂稀释法测定厄他培南、头孢噻肟、头孢他啶、头孢吡肟和氨曲南的 MIC，并根据 2011 年 CLSI 和 EUCAST 推荐的 MIC 解释标准进行解释。
共检测了 412 例非重复的 ENSE 分离株（厄他培南 MIC 值≥0.5mg/L），包括 72 株大肠埃希菌（28 株为产超广谱β-内酰胺酶（ESBL）的分离株）、167 株肺炎克雷伯菌（74 株为产 ESBL 的分离株）、115 株阴沟肠杆菌、13 株产气肠杆菌、20 株弗劳地柠檬酸杆菌、25 株黏质沙雷菌。根据 2011 年 CLSI（EUCAST）肠杆菌科 MIC 解释折点，所有 ENSE 分离株中 64%（31%）、所有大肠埃希菌分离株中 45.8%（16.7%）、所有肺炎克雷伯菌分离株中 53%（29.3%）和所有阴沟肠杆菌分离株中 86.1%（35.7%）对头孢吡肟敏感。对于产 ESBL 的 ENSE 分离株，根据 CLSI 和 EUCAST 标准，大肠埃希菌分离株中有 25%和 14.3%、肺炎克雷伯菌分离株中有 36.5%和 10.8%对头孢吡肟敏感。
尽管 CLSI-2011 和 EUCAST-2011 指南的结果存在差异，但头孢吡肟对临床分离的 ENSE 分离株具有显著的体外抗菌活性。
