JMI Laboratories, North Liberty, Iowa, USA
JMI Laboratories, North Liberty, Iowa, USA.
Antimicrob Agents Chemother. 2017 Aug 24;61(9). doi: 10.1128/AAC.00567-17. Print 2017 Sep.
We evaluated the activity of meropenem-vaborbactam against contemporary nonfastidious Gram-negative clinical isolates, including isolates with resistance phenotypes and carbapenemase genotypes. Meropenem-vaborbactam (inhibitor at 8 μg/ml) and comparators were susceptibility tested by reference broth microdilution methods against 14,304 Gram-negative clinical isolates collected worldwide during 2014. Carbapenemase-encoding genes were screened by PCR and sequencing. Meropenem-vaborbactam (MIC, ≤0.015/0.06 μg/ml) inhibited 99.1 and 99.3% of the 10,426 isolates tested at ≤1 and ≤2 μg/ml, respectively. Meropenem inhibited 97.3 and 97.7% of these isolates at the same concentrations. Against isolates displaying carbapenem-resistant (CRE) ( = 265), multidrug-resistant (MDR) ( = 1,210), and extensively drug-resistant (XDR) ( = 161) phenotypes, meropenem-vaborbactam displayed MIC values of 0.5/32, 0.03/1, and 0.5/32 μg/ml, respectively, whereas meropenem activities were 16/>32, 0.06/32, and 0.5/32 μg/ml, respectively. Among all geographic regions, the highest meropenem-vaborbactam activities were observed for CRE and MDR isolates from the United States (MIC, 0.03/1 and 0.03/0.12 μg/ml, respectively). Meropenem-vaborbactam was very active against 135 KPC producers, and all isolates were inhibited by concentrations of ≤8 μg/ml (133 isolates by concentrations of ≤2 μg/ml). This combination had limited activity against isolates producing metallo-β-lactamases (including 25 NDM-1 and 16 VIM producers) and/or oxacillinases (27 OXA-48/OXA-163 producers) that were detected mainly in Asia-Pacific and some European countries. The activity of meropenem-vaborbactam was similar to that of meropenem alone against , spp., and Meropenem-vaborbactam was active against contemporary isolates collected worldwide, and this combination demonstrated enhanced activity compared to those of meropenem and most comparator agents against CRE isolates and KPC producers, the latter of which are often MDR.
我们评估了美罗培南-法硼巴坦对当代非苛养革兰阴性临床分离株的活性，包括具有耐药表型和碳青霉烯酶基因型的分离株。采用参考肉汤微量稀释法，对 2014 年期间全球采集的 14304 株革兰阴性临床分离株进行美罗培南-法硼巴坦（抑制剂浓度为 8μg/ml）和对照药物的药敏试验。通过 PCR 和测序筛选碳青霉烯酶编码基因。美罗培南-法硼巴坦（MIC≤0.015/0.06μg/ml）对≤1μg/ml 和≤2μg/ml 时测试的 10426 株分离株中的 99.1%和 99.3%具有抑制作用。美罗培南在相同浓度下对这些分离株的抑制率分别为 97.3%和 97.7%。对 265 株显示碳青霉烯类耐药（CRE）、1210 株多重耐药（MDR）和 161 株广泛耐药（XDR）表型的分离株，美罗培南-法硼巴坦的 MIC 值分别为 0.5/32、0.03/1 和 0.5/32μg/ml，而美罗培南的活性分别为 16/>32、0.06/32 和 0.5/32μg/ml。在所有地理区域，美罗培南-法硼巴坦对来自美国的 CRE 和 MDR 分离株的活性最高（MIC 分别为 0.03/1 和 0.03/0.12μg/ml）。美罗培南-法硼巴坦对 135 株 KPC 产生菌非常活跃，所有分离株的浓度均被抑制至≤8μg/ml（133 株分离株的浓度被抑制至≤2μg/ml）。该组合对主要在亚太地区和一些欧洲国家检测到的产金属β-内酰胺酶（包括 25 株 NDM-1 和 16 株 VIM 产生菌）和/或产 oxacillinase（27 株 OXA-48/OXA-163 产生菌）的分离株活性有限。美罗培南-法硼巴坦对 、 属和 spp.的活性与美罗培南单独使用时相似。美罗培南-法硼巴坦对全球采集的当代 分离株有效，与美罗培南和大多数对照药物相比，该组合对 CRE 分离株和 KPC 产生菌的活性增强，后者通常为 MDR。
