Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
Antimicrob Agents Chemother. 2018 Jul 27;62(8). doi: 10.1128/AAC.00533-18. Print 2018 Aug.
Understanding which antimicrobial agents are likely to be active against Gram-negative bacilli can guide selection of antimicrobials for empirical therapy as mechanistic rapid diagnostics are adopted. In this study, we determined the MICs of a novel β-lactam-β-lactamase inhibitor combination, imipenem-relebactam, along with ceftolozane-tazobactam, imipenem, ertapenem, meropenem, ceftriaxone, and cefepime, against 282 drug-resistant isolates of Gram-negative bacilli. For isolates harboring ( = 110), the addition of relebactam to imipenem lowered the MIC/MIC from 16/>128 μg/ml for imipenem alone to 0.25/1 μg/ml. For isolates harboring ( = 48), the MIC/MIC of ceftolozane-tazobactam were 0.5/16 μg/ml (83% susceptible). For isolates harboring ( = 17), the MIC/MIC of ceftolozane-tazobactam were 4/8 μg/ml (47% susceptible). Imipenem-relebactam was active against most KPC-producing (but not NDM- or IMP-producing) and is an encouraging addition to the present antibiotic repertoire.
了解哪些抗菌药物可能对革兰氏阴性杆菌有效，可以指导在采用机制快速诊断时选择经验性治疗的抗菌药物。在这项研究中，我们测定了新型β-内酰胺-β-内酰胺酶抑制剂组合物亚胺培南-雷巴坦，以及头孢他啶-他唑巴坦、亚胺培南、厄他培南、美罗培南、头孢曲松和头孢吡肟对 282 株耐药革兰氏阴性杆菌分离株的 MIC。对于携带（=110）的分离株，雷巴坦的加入使亚胺培南的 MIC/MIC 从单独使用亚胺培南的 16/>128μg/ml 降低至 0.25/1μg/ml。对于携带（=48）的分离株，头孢他啶-他唑巴坦的 MIC/MIC 为 0.5/16μg/ml（83%敏感）。对于携带（=17）的分离株，头孢他啶-他唑巴坦的 MIC/MIC 为 4/8μg/ml（47%敏感）。亚胺培南-雷巴坦对大多数产 KPC（但不产 NDM 或 IMP）的菌株有效，是现有抗生素库的一个令人鼓舞的补充。
