Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Madero y Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo León C.P. 64460, Mexico.
Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Madero y Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo León C.P. 64460, Mexico.
J Glob Antimicrob Resist. 2020 Dec;23:417-419. doi: 10.1016/j.jgar.2020.10.019. Epub 2020 Nov 16.
We report the successful treatment of a bloodstream infection caused by Klebsiella pneumoniae harbouring NDM-1 using aztreonam-ceftazidime-avibactam in a neutropenic patient in whom colistin and meropenem therapy had previously failed.
A clinical isolate was evaluated to determine the presence of NDM, TEM, SHV, CTX, and CMY, and the killing kinetics of aztreonam (ATM; 4 μg/mL), aztreonam-avibactam (ATM-AVI; 4/4 μg/mL), and colistin (2 and 4 μg/mL) were tested.
ATM-AVI showed in vitro activity against the Klebsiella pneumoniae harbouring NDM-1, whereas colistin allowed re-growth.
This report supports reconsideration of use of colistin for treatment of infections caused by K. pneumoniae harbouring NDM. CZA/ATM use should be kept in mind as a treatment option, perhaps earlier than colistin.
我们报告了一例中性粒细胞减少症患者成功治疗产 NDM-1 肺炎克雷伯菌血流感染的案例，该患者先前使用多黏菌素和美罗培南治疗无效，而使用氨曲南-头孢他啶-阿维巴坦治疗有效。
评估临床分离株是否携带 NDM、TEM、SHV、CTX 和 CMY，并测试氨曲南（ATM；4μg/mL）、氨曲南-阿维巴坦（ATM-AVI；4/4μg/mL）和多黏菌素（2μg/mL 和 4μg/mL）的杀菌动力学。
ATM-AVI 对产 NDM-1 肺炎克雷伯菌具有体外活性，而多黏菌素允许细菌重新生长。
本报告支持重新考虑使用多黏菌素治疗产 NDM 肺炎克雷伯菌感染。在多黏菌素之前，应考虑使用 CZA/ATM 作为治疗选择。
