Department of Microbiology, Central Clinical Hospital in Warsaw, Warsaw, Poland.
Department of Dental Microbiology, Medical University of Warsaw, Warsaw, Poland.
Med Sci Monit. 2019 Jan 10;25:305-311. doi: 10.12659/MSM.913352.
BACKGROUND The most common etiological agents of infections in onco-hematological patients are Gram-negative rods resistant to many antimicrobials, including carbapenems. Recently, ceftolozane combined with tazobactam became a novel therapeutic option. The aim of the present study was to analyze the susceptibility to ceftolozane/tazobactam of the clinical strains of these bacteria. MATERIAL AND METHODS Material comprised rectal swabs, urine, and bronchoalveolar lavage fluid obtained from onco-hematological patients hospitalized in a clinical hospital (1050 beds) in Poland. Identification of the isolated bacteria was done by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) using the MALDI Biotyper (Bruker). Ceftolozane/tazobactam susceptibility of the isolates was assessed using antimicrobial gradient strips (E-test, BioMérieux). Antimicrobial susceptibility testing and interpretation of the results was done according to the current recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). RESULTS In total, 281 rectal swabs and 116 urine samples were tested for the presence of Gram-negative rods producing ESBL, and 531 rectal swabs and 8 bronchoalveolar lavage fluid samples were tested for the presence of Gram-negative rods resistant to carbapenems. In the analyzed period, 69 non-repetitive strains of bacteria were isolated that were in the spectrum of activity of ceftolozane/tazobactam. Among 44 clinical strains of ESBL(+) Enterobacteriaceae rods, 76% were susceptible to ceftolozane/tazobactam. All 9 strains of non-carbapenemase-producing P. aeruginosa resistant or with decreased susceptibility to carbapenems were susceptible to ceftolozane/tazobactam. CONCLUSIONS Ceftolozane/tazobactam may be an option in the therapy of infections caused by ESBL(+) strains of Enterobacteriaceae as well as non-carbapenemase-producing carbapenem-resistant strains of P. aeruginosa.
在肿瘤血液病患者中，最常见的感染病原体是对多种抗菌药物（包括碳青霉烯类）耐药的革兰氏阴性杆菌。最近，头孢洛扎/他唑巴坦成为一种新的治疗选择。本研究旨在分析这些细菌的临床分离株对头孢洛扎/他唑巴坦的敏感性。
材料包括来自波兰一家临床医院（1050 张病床）住院的肿瘤血液病患者的直肠拭子、尿液和支气管肺泡灌洗液。通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）使用 MALDI Biotyper（Bruker）进行分离菌的鉴定。使用抗菌梯度条（E 试验，生物梅里埃）评估分离株的头孢洛扎/他唑巴坦敏感性。根据当前欧洲抗菌药物敏感性试验委员会（EUCAST）的建议进行抗菌药物敏感性测试和结果解释。
共检测了 281 份直肠拭子和 116 份尿液样本，以检测产 ESBL 的革兰氏阴性杆菌，531 份直肠拭子和 8 份支气管肺泡灌洗液样本检测耐碳青霉烯类的革兰氏阴性杆菌。在分析期间，分离出 69 株非重复细菌株，这些细菌株在头孢洛扎/他唑巴坦的作用范围内。在 44 株临床 ESBL(+)肠杆菌科细菌株中，76%对头孢洛扎/他唑巴坦敏感。所有 9 株非碳青霉烯酶产的耐碳青霉烯类或对碳青霉烯类敏感性降低的铜绿假单胞菌对头孢洛扎/他唑巴坦均敏感。
头孢洛扎/他唑巴坦可能是治疗 ESBL(+)肠杆菌科菌株以及非碳青霉烯酶产的耐碳青霉烯类铜绿假单胞菌感染的一种选择。
