Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
Department of Infectious Diseases, Sir Run Run Shaw Hospital, affiliated with the Zhejiang University School of Medicine, Hangzhou, China.
Clin Infect Dis. 2020 Dec 23;71(Suppl 4):S427-S435. doi: 10.1093/cid/ciaa1519.
Considering the increasing incidence of carbapenem-resistant Enterobacteriaceae in China, this study aimed to establish the in vitro effectiveness of imipenem/relebactam (IMI/REL) on clinical Enterobacteriaceae isolates derived from intra-abdominal infections (IAIs), respiratory tract infections (RTIs), and urinary tract infections (UTIs) in China between 2015 and 2018.
In total, 8781 Enterobacteriaceae isolates from IAI, RTI, and UTI samples were collected from 22 hospitals across 7 geographic regions of China. Susceptibility to antimicrobial drugs was tested using the Clinical and Laboratory Standards Institute broth microdilution and breakpoints, and IMI/REL activity was assessed using United States Food and Drug Administration guidelines.
In 2015-2018, the most frequently identified Enterobacteriaceae species was Escherichia coli (n = 4676 [53.3%]), followed by Klebsiella pneumoniae (n = 2949 [33.6%]) and Enterobacter cloacae (n = 542 [6.2%]). The Enterobacteriaceae isolates showed 95.2% overall susceptibility to IMI/REL, of which the susceptibility rates in isolates from IAI, RTI, and UTI were 95.8%, 91.4%, and 96.6%, respectively. Overall, the susceptibilities of both intensive care unit (ICU) and non-ICU Enterobacteriaceae isolates to colistin were 92.9%, followed by IMI/REL (90.7% [95.9%]) and amikacin (83.3% [92.3%]). In addition, IMI/REL restored 66.3% susceptibility in imipenem-nonsusceptible Enterobacteriaceae.
Given their high in vitro susceptibility, Enterobacteriaceae infections in China should be considered for IMI/REL treatment, especially with isolates that are not susceptible to carbapenems.
考虑到中国碳青霉烯类耐药肠杆菌科（Carbapenem-resistant Enterobacteriaceae，CRE）的发病率不断上升，本研究旨在评估 2015 年至 2018 年期间中国腹腔内感染（Intra-abdominal Infections，IAI）、下呼吸道感染（Lower Respiratory Tract Infections，LRTI）和尿路感染（Urinary Tract Infections，UTI）中临床肠杆菌科分离株对亚胺培南/雷巴坦（Imipenem/Relbactam，IMI/REL）的体外疗效。
从中国 7 个地理区域的 22 家医院的 IAI、LRTI 和 UTI 样本中收集了 8781 株肠杆菌科分离株。使用临床和实验室标准协会肉汤微量稀释法和折点来检测抗菌药物的敏感性，根据美国食品和药物管理局的指南评估 IMI/REL 的活性。
2015 年至 2018 年，最常见的肠杆菌科菌种为大肠埃希菌（n=4676[53.3%]），其次为肺炎克雷伯菌（n=2949[33.6%]）和阴沟肠杆菌（n=542[6.2%]）。肠杆菌科分离株对 IMI/REL 的总体敏感性为 95.2%，其中 IAI、LRTI 和 UTI 分离株的敏感性分别为 95.8%、91.4%和 96.6%。总体而言，重症监护病房（Intensive Care Unit，ICU）和非 ICU 肠杆菌科分离株对黏菌素的敏感性均为 92.9%，其次是 IMI/REL（90.7%[95.9%]）和阿米卡星（83.3%[92.3%]）。此外，IMI/REL 恢复了 66.3%对亚胺培南耐药的肠杆菌科的敏感性。
鉴于其体外高度敏感性，中国的肠杆菌科感染应考虑使用 IMI/REL 治疗，特别是对于那些对碳青霉烯类药物不敏感的分离株。
