Gupta Shilpi, Kumar Mahadevan, Shergill Shelinder P S, Tandel Kundan
Department of Microbiology, Military Hospital, Bhopal, India.
Department of Microbiology, Bharati Vidyapeeth University Medical College, Pune, India.
Afr J Lab Med. 2020 Dec 10;9(1):991. doi: 10.4102/ajlm.v9i1.991. eCollection 2020.
Multi-drug resistant (MDR) Gram-negative bacteria are an emerging threat, both in hospital and community settings. As very few antibiotics are effective against such infections, the need of the hour is a new antibiotic or drug combination which can overcome the effect of extended-spectrum β-lactamases (ESBL) and metallo β-lactamases (MBL). A new antibiotic combination of ceftriaxone, sulbactam and disodium edetate (CSE) has recently been proposed to tackle the MDR organisms.
Our study was carried out to assess the susceptibility of ESBL- and MBL-producing Gram-negative organisms to CSE.
The study was conducted in a tertiary-care hospital in Delhi, India, from February 2017 to June 2017. A total of 179 MDR (85 ESBL + 94 MBL) Gram-negative isolates from various clinical samples, identified by an automated system (Vitek 2) were tested against CSE using the Kirby-Bauer disc diffusion method. Susceptibility to CSE was recorded based on interpretative zone sizes of ceftriaxone as per 2017 Clinical and Laboratory Standards Institute guidelines.
The most common isolate was (76/179; 42.4%) followed by (53/179; 29.6%) and (27/179; 15.1%). The susceptibility of ESBL- and MBL-producing Gram-negative isolates to CSE was found to be 58/85 (68.2%) for ESBL and 37/94 (39.4%) for MBL.
The susceptibility results obtained for CSE against ESBL-producing organisms is promising. It has the potential to emerge as a carbapenem-sparing antibiotic, active against ESBL-producing strains. Further clinical studies are required to establish the clinical efficacy of CSE against MDR pathogens.
耐多药（MDR）革兰氏阴性菌在医院和社区环境中都是一种新出现的威胁。由于很少有抗生素能有效对抗此类感染，当务之急是需要一种新的抗生素或药物组合，能够克服超广谱β-内酰胺酶（ESBL）和金属β-内酰胺酶（MBL）的作用。最近有人提出一种新的头孢曲松、舒巴坦和依地酸二钠（CSE）抗生素组合来对付耐多药微生物。
我们开展本研究以评估产ESBL和MBL的革兰氏阴性菌对CSE的敏感性。
本研究于2017年2月至2017年6月在印度德里一家三级医疗医院进行。使用自动系统（Vitek 2）从各种临床样本中鉴定出总共179株耐多药（85株产ESBL + 94株产MBL）革兰氏阴性分离株，采用 Kirby-Bauer 纸片扩散法对其进行CSE检测。根据2017年临床和实验室标准协会指南，依据头孢曲松的解释性抑菌圈大小记录对CSE的敏感性。
最常见的分离株是[具体菌名未给出]（76/179；42.4%），其次是[具体菌名未给出]（53/179；29.6%）和[具体菌名未给出]（27/179；15.1%）。产ESBL和产MBL的革兰氏阴性分离株对CSE的敏感性在产ESBL菌株中为58/85（68.2%），在产MBL菌株中为37/94（39.4%）。
CSE对产ESBL菌株的敏感性结果很有前景。它有潜力成为一种可替代碳青霉烯类的抗生素，对产ESBL菌株有活性。需要进一步的临床研究来确定CSE对耐多药病原体的临床疗效。
