Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, Crete, Greece.
University of Crete Medical School, Heraklion, Crete, Greece.
Eur J Clin Microbiol Infect Dis. 2021 Aug;40(8):1755-1759. doi: 10.1007/s10096-021-04197-3. Epub 2021 Feb 17.
The spread of multidrug-resistant (MDR), metallo-β-lactamase (MBL)-producing Klebsiella pneumoniae represents a major therapeutic challenge. The newly introduced β-lactam-β-lactamase inhibitors (BLBLIs), ceftazidime/avibactam (CAZ/AVI), meropenem/vaborbactam (M/V), and imipenem/relebactam (I/R) are inactive against MBLs. The aim of this study was to evaluate the in vitro efficacy of aztreonam (ATM) in combination with CAZ/AVI, M/V, and I/R against 40 MDR, MBL-producing, and serine-β-lactamases co-producing Klebsiella pneumoniae using the Etest method. Synergy was defined as a fractional inhibitory concentration index ≤0.5. All isolates were resistant to ATM, CAZ/AVI, and I/R and 38/40 (95%) were resistant to M/V. Synergy was observed in 97.5% in the combinations CAZ/AVI-ATM, and I/R-ATM and in 72.5% in the combination M/V-ATM. Further clinical studies are required to confirm the efficacy of these antimicrobial combinations.
多药耐药（MDR）、产金属β-内酰胺酶（MBL）的肺炎克雷伯菌的传播是一个主要的治疗挑战。新引入的β-内酰胺-β-内酰胺酶抑制剂（BLBLIs），头孢他啶/阿维巴坦（CAZ/AVI）、美罗培南/瓦博巴坦（M/V）和亚胺培南/雷利巴坦（I/R）对 MBL 无活性。本研究旨在使用 Etest 法评估氨曲南（ATM）与 CAZ/AVI、M/V 和 I/R 联合应用对 40 株 MDR、产 MBL 和同时产丝氨酸β-内酰胺酶的肺炎克雷伯菌的体外疗效。协同作用定义为部分抑菌浓度指数≤0.5。所有分离株均对 ATM、CAZ/AVI 和 I/R 耐药，38/40（95%）对 M/V 耐药。CAZ/AVI-ATM 和 I/R-ATM 联合用药的协同作用为 97.5%，M/V-ATM 联合用药的协同作用为 72.5%。需要进一步的临床研究来证实这些抗菌药物联合用药的疗效。
