Martins Andreza Francisco, Bail Larissa, Ito Carmen Antonia Sanches, da Silva Nogueira Keite, Dalmolin Tanise Vendruscolo, Martins Amanda Silva, Rocha Jaime Luis Lopes, Serio Alisa W, Tuon Felipe Francisco
Division of Microbiology, Universidade Federal do Rio Grande do Sul.
Division of Microbiology, Universidade Estadual de Ponta Grossa.
Diagn Microbiol Infect Dis. 2018 Mar;90(3):228-232. doi: 10.1016/j.diagmicrobio.2017.11.004. Epub 2017 Nov 10.
Plazomicin is a next-generation aminoglycoside with activity against Enterobacteriaceae, including carbapenemase-producing Enterobacteriaceae (CPE). The aim of this study was to evaluate the activity of plazomicin against CPE (Klebsiella spp., Escherichia coli, Serratia spp., Enterobacter spp., Citrobacter spp., Morganella spp., Proteus spp., Providencia spp.) from different Brazilian hospitals. A total of 4000 carbapenem-resistant Enterobacteriaceae isolates were collected from clinical samples in 50 Brazilian hospitals during 2013-2015. Of these, 499 carbapenem-resistant isolates (CLSI criteria) were selected for further evaluation via broth microdilution to assess for the activity of plazomicin, colistin, tigecycline, meropenem, amikacin, and gentamicin. Additionally, the isolates were assessed for the presence of carbapenemase genes (bla, bla, bla, bla, bla, bla, and bla) by polymerase chain reaction (PCR). When PCR was positive to bla, bla, bla, and bla the carbapenemase genes were sequenced. bla was the most prevalent carbapenemase gene found (n=397), followed by bla (n=81), bla (n=12), and bla (n=3). Other genes were identified in only 1 isolate each: bla, bla, bla, bla, and bla. One isolate had 2 carbapenemase genes (bla and bla). Thirty-three percent of the isolates were nonsusceptible to colistin, 24% to tigecycline, 97% to meropenem, 51% to amikacin, and 81% to gentamicin (via EUCAST criteria). The plazomicin MIC was 0.5/64mg/L, with 85% of MICs ≤2mg/L and 87% of MICs ≤4mg/L. Elevated MICs to plazomicin were not associated with a specific carbapenemase or bacterial species. The MICs of plazomicin against CPE were lower than those of other aminoglycosides. Plazomicin is a promising drug for the treatment of CPE infections.
普拉佐米星是一种新一代氨基糖苷类药物,对肠杆菌科细菌具有活性,包括产碳青霉烯酶的肠杆菌科细菌(CPE)。本研究的目的是评估普拉佐米星对来自巴西不同医院的CPE(克雷伯菌属、大肠杆菌、沙雷菌属、肠杆菌属、柠檬酸杆菌属、摩根菌属、变形杆菌属、普罗威登斯菌属)的活性。2013年至2015年期间,从巴西50家医院的临床样本中总共收集了4000株耐碳青霉烯类肠杆菌科细菌分离株。其中,499株耐碳青霉烯类分离株(根据CLSI标准)通过肉汤微量稀释法进行进一步评估,以评估普拉佐米星、黏菌素、替加环素、美罗培南、阿米卡星和庆大霉素的活性。此外,通过聚合酶链反应(PCR)评估分离株中碳青霉烯酶基因(bla、bla、bla、bla、bla、bla和bla)的存在情况。当PCR对bla、bla、bla和bla呈阳性时,对碳青霉烯酶基因进行测序。bla是最常见的碳青霉烯酶基因(n = 397),其次是bla(n = 81)、bla(n = 12)和bla(n = 3)。其他基因在每个分离株中仅鉴定出1个:bla、bla、bla、bla和bla。1个分离株有2个碳青霉烯酶基因(bla和bla)。33%的分离株对黏菌素不敏感,24%对替加环素不敏感,97%对美罗培南不敏感,51%对阿米卡星不敏感,81%对庆大霉素不敏感(根据EUCAST标准)。普拉佐米星的MIC为0.5/64mg/L,85%的MIC≤2mg/L,87%的MIC≤4mg/L。普拉佐米星的MIC升高与特定的碳青霉烯酶或细菌种类无关。普拉佐米星对CPE的MIC低于其他氨基糖苷类药物。普拉佐米星是治疗CPE感染的一种有前景的药物。