Sakanashi Daisuke, Miyazaki Narimi, Kawamoto Yuzuka, Ohno Tomoko, Yamada Atsuko, Koita Isao, Miyajima Setsuo, Suematsu Hiroyuki, Hagihara Mao, Asai Nobuhiro, Koizumi Yusuke, Yamagishi Yuka, Mikamo Hiroshige
Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan.
Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan.
J Infect Chemother. 2019 Jan;25(1):75-77. doi: 10.1016/j.jiac.2018.07.005. Epub 2018 Aug 9.
We determined the optimal antimicrobial in the sodium mercaptoacetic acid double disk synergy test (SMA-DDST) for the detection of IMP-1-producing Pseudomonas aeruginosa isolates in Japan and evaluated the performance of the test. Fifty-four P. aeruginosa clinical isolates were tested, including 39 IMP-1 producers and 15 non-metallo-β-lactamase (MBL)-producing carbapenem- and ceftazidime (CAZ)-resistant isolates. The SMA-DDST was performed with CAZ, cefepime (CFPM), imipenem (IPM), meropenem (MEPM), doripenem (DRPM), or biapenem (BIPM)-containing disks. The sensitivity of the SMA-DDST with CAZ, CFPM, IPM, MEPM, DRPM, and BIPM was 39/39 (100%), 36/39 (92%), 18/39 (46%), 8/39 (21%), 19/39 (49%), and 36/39 (92%), respectively. The specificity was 15/15 (100%) for all SMA-DDSTs. This suggests that the isolates may have a resistance mechanism other than MBL production for IPM, MEPM, or DRPM. Since the CAZ resistance mechanism in P. aeruginosa is the same as that of CFPM, but differs from that of carbapenems, we conclude that combining CAZ with BIPM SMA-DDSTs can prevent any failure in the detection of IMP-1-producing P. aeruginosa.
我们在日本通过巯基乙酸钠双纸片协同试验（SMA-DDST）确定了用于检测产IMP-1的铜绿假单胞菌分离株的最佳抗菌药物，并评估了该试验的性能。对54株铜绿假单胞菌临床分离株进行了检测，其中包括39株产IMP-1的菌株和15株不产金属β-内酰胺酶（MBL）但对碳青霉烯类和头孢他啶（CAZ）耐药的菌株。SMA-DDST使用含CAZ、头孢吡肟（CFPM）、亚胺培南（IPM）、美罗培南（MEPM）、多黏菌素（DRPM）或比阿培南（BIPM）的纸片进行。CAZ、CFPM、IPM、MEPM、DRPM和BIPM的SMA-DDST敏感性分别为39/39（100%）、36/39（92%）、18/39（46%）、8/39（21%）、19/39（49%）和36/39（92%）。所有SMA-DDST的特异性均为15/15（100%）。这表明这些分离株对IPM、MEPM或DRPM可能存在除MBL产生之外的耐药机制。由于铜绿假单胞菌对CAZ的耐药机制与CFPM相同，但与碳青霉烯类不同，我们得出结论，将CAZ与BIPM的SMA-DDST联合使用可以防止在检测产IMP-1的铜绿假单胞菌时出现任何漏检情况。
