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2008-2016 年,作为 CANWARD 研究的一部分,在加拿大各地收集了包括 MDR 和 XDR 分离株在内的对非敏感的铜绿假单胞菌临床分离株,评估头孢洛扎/他唑巴坦的体外活性。

In vitro activity of ceftolozane/tazobactam versus antimicrobial non-susceptible Pseudomonas aeruginosa clinical isolates including MDR and XDR isolates obtained from across Canada as part of the CANWARD study, 2008-16.

机构信息

Department of Internal Medicine, Section of Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada.

Diagnostic Services Manitoba, Winnipeg, Manitoba, Canada.

出版信息

J Antimicrob Chemother. 2018 Mar 1;73(3):703-708. doi: 10.1093/jac/dkx468.

Abstract

OBJECTIVES

Ceftolozane/tazobactam is a novel β-lactam β-lactamase inhibitor combination with a broad spectrum of activity that includes Pseudomonas aeruginosa. The purpose of this study was to evaluate the in vitro activity of ceftolozane/tazobactam and relevant comparators versus a large collection of antimicrobial non-susceptible P. aeruginosa clinical isolates recovered from patients across Canada (CANWARD, 2008-16).

METHODS

Susceptibility testing was performed on P. aeruginosa clinical isolates obtained from sentinel hospitals across Canada between January 2008 and December 2016 using broth microdilution, as described by the CLSI. MDR P. aeruginosa were defined as isolates that tested non-susceptible to at least one antimicrobial from ≥3 classes. XDR P. aeruginosa were defined as isolates that tested non-susceptible to at least one antimicrobial from ≥5 classes.

RESULTS

In total, 3229 P. aeruginosa isolates were obtained as a part of CANWARD. Ceftolozane/tazobactam was the most active antimicrobial evaluated, with 98.3% of isolates testing susceptible. The percentage of antimicrobial non-susceptible isolates that remained susceptible to ceftolozane/tazobactam ranged from 85.3% (amikacin non-susceptible subset) to 95.0% (ciprofloxacin non-susceptible subset). Four-hundred and sixty-two P. aeruginosa isolates were MDR (14.3% of all isolates tested) and 84 were XDR (2.6% of all isolates tested). Ceftolozane/tazobactam demonstrated excellent in vitro activity versus the MDR and XDR isolates, with 90.5% and 78.6% remaining susceptible, respectively.

CONCLUSIONS

Ceftolozane/tazobactam demonstrated excellent in vitro activity against antimicrobial non-susceptible P. aeruginosa clinical isolates, including MDR and XDR subsets. It may prove useful in the treatment of infections caused by these organisms.

摘要

目的

头孢洛扎/他唑巴坦是一种新型β-内酰胺类β-内酰胺酶抑制剂复方制剂,具有广泛的活性,包括铜绿假单胞菌。本研究的目的是评估头孢洛扎/他唑巴坦和相关对照药物对来自加拿大各地患者的大量抗菌非敏感铜绿假单胞菌临床分离株的体外活性(CANWARD,2008-16)。

方法

使用肉汤微量稀释法,按照 CLSI 的描述,对 2008 年 1 月至 2016 年 12 月期间从加拿大各地监测医院获得的铜绿假单胞菌临床分离株进行药敏试验。多重耐药铜绿假单胞菌定义为至少对 3 类抗菌药物不敏感的分离株。广泛耐药铜绿假单胞菌定义为至少对 5 类抗菌药物不敏感的分离株。

结果

CANWARD 共获得 3229 株铜绿假单胞菌分离株。头孢洛扎/他唑巴坦是评估的最有效的抗菌药物,98.3%的分离株测试敏感。对头孢洛扎/他唑巴坦仍敏感的抗菌药物非敏感分离株的百分比范围从 85.3%(阿米卡星非敏感亚组)到 95.0%(环丙沙星非敏感亚组)。462 株铜绿假单胞菌为多重耐药菌(所有测试分离株的 14.3%),84 株为广泛耐药菌(所有测试分离株的 2.6%)。头孢洛扎/他唑巴坦对 MDR 和 XDR 分离株具有极好的体外活性,分别有 90.5%和 78.6%的分离株仍敏感。

结论

头孢洛扎/他唑巴坦对非敏感的铜绿假单胞菌临床分离株,包括 MDR 和 XDR 亚群,具有极好的体外活性。它可能对治疗这些病原体引起的感染有用。

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