产超广谱β-内酰胺酶 GES-6 的获得导致. 对头孢洛扎他巴坦联合制剂的耐药性
Acquisition of Extended-Spectrum β-Lactamase GES-6 Leading to Resistance to Ceftolozane-Tazobactam Combination in .
机构信息
Emerging Antibiotic Resistance Unit, Medical and Molecular Microbiology, Department of Medicine, University of Fribourg, Fribourg, Switzerland
INSERM European Unit (LEA), IAME, Paris, France.
出版信息
Antimicrob Agents Chemother. 2018 Dec 21;63(1). doi: 10.1128/AAC.01809-18. Print 2019 Jan.
Abstract
A clinical isolate resistant to all β-lactams, including ceftolozane-tazobactam and carbapenems, was recovered. It belonged to sequence type 235 and produced the extended-spectrum β-lactamase (ESBL) GES-6 differing from GES-1 by two amino acid substitutions (E104K and G170S). GES-6 possessed an increased hydrolytic activity toward carbapenems and to ceftolozane and a decreased susceptibility to β-lactamase inhibitors compared to GES-1, except for avibactam. We show here that resistance to ceftolozane-tazobactam may occur through acquisition of a specific ESBL in but that ceftazidime-avibactam combination remains an effective alternative.
摘要
临床分离株对所有β-内酰胺类抗生素（包括头孢洛扎他唑巴坦和碳青霉烯类）均耐药，该分离株属于 235 型序列，产生了不同于 GES-1 的超广谱β-内酰胺酶（ESBL）GES-6，其存在两种氨基酸取代（E104K 和 G170S）。与 GES-1 相比，GES-6 对碳青霉烯类和头孢洛扎他唑巴坦的水解活性增加，对β-内酰胺酶抑制剂的敏感性降低，除了阿维巴坦。我们在这里表明，对头孢洛扎他唑巴坦的耐药性可能是通过获得特定的 ESBL 而产生的，但头孢他啶-阿维巴坦联合用药仍然是一种有效的替代方法。
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