JMI Laboratories, North Liberty, Iowa, USA
JMI Laboratories, North Liberty, Iowa, USA.
Antimicrob Agents Chemother. 2017 Oct 24;61(11). doi: 10.1128/AAC.01045-17. Print 2017 Nov.
The activity of ceftazidime-avibactam and many comparator agents was determined against various resistant subsets of organisms selected among 36,380 and 7,868 isolates. The isolates were consecutively collected from 94 U.S. hospitals, and all isolates were tested for susceptibility by reference broth microdilution methods in a central monitoring laboratory (JMI Laboratories). isolates resistant to carbapenems (CRE) and/or ceftazidime-avibactam (MIC ≥ 16 μg/ml) were evaluated for the presence of genes encoding extended-spectrum β-lactamases and carbapenemases. Ceftazidime-avibactam inhibited >99.9% of all at the susceptible breakpoint of ≤8 μg/ml and was active against multidrug-resistant (MDR; = 2,953; MIC, 0.25/1 μg/ml; 99.2% susceptible), extensively drug-resistant (XDR; = 448; MIC, 0.5/2 μg/ml; 97.8% susceptible), and CRE ( = 513; MIC, 0.5/2 μg/ml; 97.5% susceptible) isolates. Only 82.2% of MDR ( = 2,953) and 64.2% of ceftriaxone-nonsusceptible ( = 1,063) isolates were meropenem susceptible. Among (22.2% ceftazidime nonsusceptible), 99.8% of the isolates, including 99.3% of the ceftazidime-nonsusceptible isolates, were ceftazidime-avibactam susceptible. Only 23 of 36,380 (0.06%) isolates were ceftazidime-avibactam nonsusceptible, including 9 metallo-β-lactamase producers and 2 KPC-producing strains with porin alteration; the remaining 12 strains showed negative results for all β-lactamases tested. Ceftazidime-avibactam showed potent activity against (MIC, 2/4 μg/ml; 97.1% susceptible), including MDR (MIC, 4/16 μg/ml; 86.5% susceptible) isolates, and inhibited 71.8% of isolates nonsusceptible to meropenem, piperacillin-tazobactam, and ceftazidime ( = 628). In summary, ceftazidime-avibactam demonstrated potent activity against a large collection ( = 44,248) of contemporary Gram-negative bacilli isolated from U.S. patients, including organisms resistant to most currently available agents, such as CRE and meropenem-nonsusceptible .
该活性的头孢他啶-阿维巴坦和许多比较剂的活动是针对各种选定的耐药亚群的生物决定 36380 和 7868 株。 株连续从 94 美国医院收集，所有的分离物都通过参考肉汤微量稀释法在中央监测实验室（JMI 实验室）进行了药敏试验。 对碳青霉烯类药物（CRE）和/或头孢他啶-阿维巴坦（MIC≥16μg/ml）耐药的分离株评估了编码超广谱β-内酰胺酶和碳青霉烯酶的基因的存在。 头孢他啶-阿维巴坦抑制>99.9%的所有 在敏感折点≤8μg/ml，并对多药耐药（MDR; = 2953;MIC，0.25/1μg/ml;99.2%敏感）、广泛耐药（XDR; = 448;MIC，0.5/2μg/ml;97.8%敏感）和 CRE（=513;MIC，0.5/2μg/ml;97.5%敏感）分离物有活性。 只有 82.2%的 MDR（=2953）和 64.2%的头孢曲松不敏感（=1063）分离物对美罗培南敏感。 在 （22.2%头孢他啶不敏感）中，99.8%的分离株，包括 99.3%的头孢他啶不敏感分离株，对头孢他啶-阿维巴坦敏感。 只有 36380 中的 23 株（0.06%）分离物对头孢他啶-阿维巴坦不敏感，包括 9 株金属β-内酰胺酶产生菌和 2 株带有孔改变的 KPC 产生菌；其余 12 株对所有检测的β-内酰胺酶均呈阴性结果。 头孢他啶-阿维巴坦对 （MIC，2/4μg/ml；97.1%敏感）表现出强大的活性，包括 MDR（MIC，4/16μg/ml；86.5%敏感）分离株，并抑制 71.8%对美罗培南、哌拉西林-他唑巴坦和头孢他啶不敏感的分离株（=628）。 总之，头孢他啶-阿维巴坦对来自美国患者的大量当代革兰氏阴性杆菌（=44248 株）表现出强大的活性，包括对大多数现有药物（如 CRE 和美罗培南不敏感的 ）耐药的生物体。
