Karlowsky James A, Bouchillon Samuel K, El Mahdy Kotb Ramy, Mohamed Naglaa, Stone Gregory G, Sahm Daniel F
IHMA, Schaumburg, IL, USA.
Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
JAC Antimicrob Resist. 2021 Jun 1;3(2):dlab067. doi: 10.1093/jacamr/dlab067. eCollection 2021 Jun.
To assess the activity of ceftazidime/avibactam against a recent, 2015-18, collection of clinical isolates of Gram-negative bacilli from Middle Eastern and African countries with a focus on isolates from ICUs and with MDR and difficult-to-treat resistance (DTR) phenotypes.
Antimicrobial susceptibility testing of 4608 isolates of Enterobacterales (997 isolates from ICU patients) and 1358 isolates of (374 isolates from ICU patients) was performed by CLSI broth microdilution methodology in a central laboratory. MICs were interpreted using both CLSI (2020) and EUCAST (2020) MIC breakpoints.
Most isolates of Enterobacterales (Middle East: ICU, 99.1% susceptible, non-ICU, 99.1%; Africa: ICU, 96.9% susceptible, non-ICU, 98.3%) and (Middle East: ICU, 93.4%, non-ICU, 92.1%; Africa: ICU, 89.8%; non-ICU, 94.1%) were susceptible to ceftazidime/avibactam. Applying CLSI and EUCAST breakpoints, MDR rates were similar for Enterobacterales (27.8%-36.0% of isolates) and (25.0%-36.4%) while DTR rates were lower for Enterobacterales (1.6%-1.8%) than for (5.2%-7.4%). Percentage susceptible rates for ceftazidime/avibactam for MDR Enterobacterales were 96.8%-97.5% (Middle East) and 92.5%-94.3% (Africa) while rates for were 70.1%-80.0% (Middle East) and 69.5%-78.2% (Africa). 60.5%-65.8% (Middle East) and 38.9%-52.2% (Africa) of isolates of Enterobacterales with DTR phenotypes were ceftazidime/avibactam susceptible as were 29.2%-31.1% (Middle East) and 28.2%-35.8% (Africa) of DTR .
Overall, the isolates of Enterobacterales and tested from Middle Eastern and African countries were highly susceptible to ceftazidime/avibactam. Most MDR and many DTR isolates of Enterobacterales and were susceptible to ceftazidime/avibactam.
评估2015 - 2018年从中东和非洲国家收集的近期革兰氏阴性杆菌临床分离株对头孢他啶/阿维巴坦的活性，重点关注重症监护病房（ICU）分离株以及具有多重耐药（MDR）和难治性耐药（DTR）表型的分离株。
在一个中央实验室采用美国临床和实验室标准协会（CLSI）肉汤微量稀释法，对4608株肠杆菌科细菌（997株来自ICU患者）和1358株[此处原文缺失细菌名称]（374株来自ICU患者）进行药敏试验。使用CLSI（2020）和欧洲抗菌药物敏感性试验委员会（EUCAST，2020）的最低抑菌浓度（MIC）断点来解释MIC结果。
大多数肠杆菌科细菌分离株（中东地区：ICU，99.1%敏感，非ICU，99.1%；非洲地区：ICU，96.9%敏感，非ICU，98.3%）和[此处原文缺失细菌名称]（中东地区：ICU，93.4%，非ICU，92.1%；非洲地区：ICU，89.8%；非ICU，94.1%）对头孢他啶/阿维巴坦敏感。应用CLSI和EUCAST断点，肠杆菌科细菌的MDR率相似（分离株的27.8% - 36.0%），[此处原文缺失细菌名称]的MDR率也相似（25.0% - 36.4%），而肠杆菌科细菌的DTR率（1.6% - 1.8%）低于[此处原文缺失细菌名称]（5.2% - 7.4%）。MDR肠杆菌科细菌对头孢他啶/阿维巴坦的敏感率在中东地区为96.8% - 97.5%，在非洲地区为92.5% - 94.3%，而[此处原文缺失细菌名称]的敏感率在中东地区为70.1% - 80.0%，在非洲地区为69.5% - 78.2%。具有DTR表型的肠杆菌科细菌分离株在中东地区有60.5% - 65.8%、在非洲地区有38.9% - 52.2%对头孢他啶/阿维巴坦敏感，具有DTR表型的[此处原文缺失细菌名称]在中东地区有29.2% - 31.1%、在非洲地区有28.2% - 35.8%对头孢他啶/阿维巴坦敏感。
总体而言，从中东和非洲国家检测的肠杆菌科细菌和[此处原文缺失细菌名称]分离株对头孢他啶/阿维巴坦高度敏感。大多数MDR和许多DTR的肠杆菌科细菌和[此处原文缺失细菌名称]分离株对头孢他啶/阿维巴坦敏感。
