携带AAC(6')-Ib的产KPC肺炎克雷伯菌菌株对阿米卡星表现出中度耐药。
KPC-producing Klebsiella pneumoniae strains that harbor AAC(6')-Ib exhibit intermediate resistance to amikacin.
作者信息
Bremmer Derek N, Clancy Cornelius J, Press Ellen G, Almaghrabi Reem, Chen Liang, Doi Yohei, Nguyen M Hong, Shields Ryan K
机构信息
Department of Pharmacy and Therapeutics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
出版信息
Antimicrob Agents Chemother. 2014 Dec;58(12):7597-600. doi: 10.1128/AAC.03831-14. Epub 2014 Oct 6.
Abstract
The aminoglycoside-modifying enzyme AAC(6')-Ib is common among carbapenem-resistant Klebsiella pneumoniae (CR-Kp) strains. We investigated amikacin (AMK) activity against 20 AAC(6')-Ib-producing CR-Kp strains. MICs clustered at 16 to 32 μg/ml. By the time-kill study, AMK (1× and 4× the MIC) was bactericidal against 30% and 85% of the strains, respectively. At achievable human serum concentrations, however, the majority of strains showed regrowth, suggesting that AAC(6')-Ib confers intermediate AMK resistance. AMK and trimethoprim-sulfamethoxazole (TMP-SMX) were synergistic against 90% of the strains, indicating that the combination may overcome resistance.
摘要
氨基糖苷修饰酶AAC(6')-Ib在耐碳青霉烯肺炎克雷伯菌（CR-Kp）菌株中很常见。我们研究了阿米卡星（AMK）对20株产AAC(6')-Ib的CR-Kp菌株的活性。最低抑菌浓度（MIC）集中在16至32μg/ml。通过时间杀菌研究，AMK（1倍和4倍MIC）分别对30%和85%的菌株具有杀菌作用。然而，在可达到的人体血清浓度下，大多数菌株出现再生长，这表明AAC(6')-Ib赋予了对AMK的中度耐药性。AMK与复方磺胺甲恶唑（TMP-SMX）对90%的菌株具有协同作用，这表明联合用药可能克服耐药性。
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