造血细胞移植患者血流感染碳青霉烯类耐药铜绿假单胞菌的临床结果及体外药敏组合对其的影响。
Clinical outcome from hematopoietic cell transplant patients with bloodstream infection caused by carbapenem-resistant P. aeruginosa and the impact of antimicrobial combination in vitro.
机构信息
Department of Infectious Diseases of Faculdade de Medicina, University of Sao Paulo, São Paulo, Brazil.
Department of Haematology, Hemotherapy and Cellular Therapy of Faculdade de Medicina, University of Sao Paulo, São Paulo, Brazil.
出版信息
Eur J Clin Microbiol Infect Dis. 2022 Feb;41(2):313-317. doi: 10.1007/s10096-021-04361-9. Epub 2021 Oct 15.
Bloodstream infection (BSI) caused by carbapenem-resistant P. aeruginosa (CRPA) has high mortality in hematopoietic stem cell transplant (HSCT) recipients. We performed MIC, checkerboard, time-kill assay, PFGE, PCR, and whole genome sequence and described the clinical outcome through Epi Info comparing the antimicrobial combination in vitro. Mortality was higher in BSI caused by CRPA carrying the lasB virulence gene. The isolates were 97% resistant to meropenem displaying synergistic effect to 57% in combination with colistin. Seventy-three percent of the isolates harbored bla and Tn4371 and belonged to ST277. The synergistic effect in vitro with meropenem with colistin appeared to be a better therapeutic option.
血流感染（BSI）由耐碳青霉烯铜绿假单胞菌（CRPA）引起，在造血干细胞移植（HSCT）受者中死亡率很高。我们进行了 MIC、棋盘、时间杀伤试验、PFGE、PCR 和全基因组测序，并通过 Epi Info 描述了临床结果，比较了体外的抗菌组合。携带 lasB 毒力基因的 CRPA 引起的 BSI 死亡率更高。这些分离株对美罗培南的耐药率为 97%，与多粘菌素联合使用时显示协同作用，为 57%。73%的分离株携带 bla 和 Tn4371，属于 ST277。体外美罗培南与多粘菌素联合使用的协同作用似乎是一种更好的治疗选择。
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