评估头孢他啶/阿维巴坦和头孢洛扎/他唑巴坦对来自卡塔尔的多重耐药铜绿假单胞菌分离株的体外活性。
Evaluation of in vitro activity of ceftazidime/avibactam and ceftolozane/tazobactam against MDR Pseudomonas aeruginosa isolates from Qatar.
机构信息
Microbiology Division, Hamad Medical Corporation, Doha, Qatar.
The Life Science Centre, School of Science and Technology, Örebro University, Örebro, Sweden.
出版信息
J Antimicrob Chemother. 2019 Dec 1;74(12):3497-3504. doi: 10.1093/jac/dkz379.
OBJECTIVES
To investigate the in vitro activity of ceftazidime/avibactam and ceftolozane/tazobactam against clinical isolates of MDR Pseudomonas aeruginosa from Qatar, as well as the mechanisms of resistance.
METHODS
MDR P. aeruginosa isolated between October 2014 and September 2015 from all public hospitals in Qatar were included. The BD PhoenixTM system was used for identification and initial antimicrobial susceptibility testing, while Liofilchem MIC Test Strips (Liofilchem, Roseto degli Abruzzi, Italy) were used for confirmation of ceftazidime/avibactam and ceftolozane/tazobactam susceptibility. Ten ceftazidime/avibactam- and/or ceftolozane/tazobactam-resistant isolates were randomly selected for WGS.
RESULTS
A total of 205 MDR P. aeruginosa isolates were included. Of these, 141 (68.8%) were susceptible to ceftazidime/avibactam, 129 (62.9%) were susceptible to ceftolozane/tazobactam, 121 (59.0%) were susceptible to both and 56 (27.3%) were susceptible to neither. Twenty (9.8%) isolates were susceptible to ceftazidime/avibactam but not to ceftolozane/tazobactam and only 8 (3.9%) were susceptible to ceftolozane/tazobactam but not to ceftazidime/avibactam. Less than 50% of XDR isolates were susceptible to ceftazidime/avibactam or ceftolozane/tazobactam. The 10 sequenced isolates belonged to six different STs and all produced AmpC and OXA enzymes; 5 (50%) produced ESBL and 4 (40%) produced VIM enzymes.
CONCLUSIONS
MDR P. aeruginosa susceptibility rates to ceftazidime/avibactam and ceftolozane/tazobactam were higher than those to all existing antipseudomonal agents, except colistin, but were less than 50% in extremely resistant isolates. Non-susceptibility to ceftazidime/avibactam and ceftolozane/tazobactam was largely due to the production of ESBL and VIM enzymes. Ceftazidime/avibactam and ceftolozane/tazobactam are possible options for some patients with MDR P. aeruginosa in Qatar.
目的
研究头孢他啶/阿维巴坦和头孢洛扎/他唑巴坦对来自卡塔尔的耐多药铜绿假单胞菌临床分离株的体外活性，以及耐药机制。
方法
纳入 2014 年 10 月至 2015 年 9 月间来自卡塔尔所有公立医院的耐多药铜绿假单胞菌。使用 BD PhoenixTM 系统进行鉴定和初始抗菌药物敏感性检测，而 Liofilchem MIC 测试条（Liofilchem，意大利罗塞托 degli Abruzzi）用于确认头孢他啶/阿维巴坦和头孢洛扎/他唑巴坦的敏感性。随机选择 10 株对头孢他啶/阿维巴坦和/或头孢洛扎/他唑巴坦耐药的分离株进行 WGS。
结果
共纳入 205 株耐多药铜绿假单胞菌。其中，141 株（68.8%）对头孢他啶/阿维巴坦敏感，129 株（62.9%）对头孢洛扎/他唑巴坦敏感，121 株（59.0%）对两者均敏感，56 株（27.3%）对两者均不敏感。20 株（9.8%）分离株对头孢他啶/阿维巴坦敏感但对头孢洛扎/他唑巴坦不敏感，仅 8 株（3.9%）对头孢洛扎/他唑巴坦敏感但对头孢他啶/阿维巴坦不敏感。XDR 分离株中不到 50%对头孢他啶/阿维巴坦或头孢洛扎/他唑巴坦敏感。10 株测序分离株属于六种不同的 ST，均产生 AmpC 和 OXA 酶；5 株（50%）产生 ESBL，4 株（40%）产生 VIM 酶。
结论
与所有现有抗假单胞菌药物（除多粘菌素外）相比，耐多药铜绿假单胞菌对头孢他啶/阿维巴坦和头孢洛扎/他唑巴坦的敏感性率更高，但在极耐药分离株中不到 50%。对头孢他啶/阿维巴坦和头孢洛扎/他唑巴坦的不敏感主要是由于 ESBL 和 VIM 酶的产生。头孢他啶/阿维巴坦和头孢洛扎/他唑巴坦可能是卡塔尔部分耐多药铜绿假单胞菌患者的选择。
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