Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, Thailand.
Clinical Laboratory Section, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
J Glob Antimicrob Resist. 2022 Mar;28:8-11. doi: 10.1016/j.jgar.2021.11.015. Epub 2021 Dec 16.
Treatment options are limited for melioidosis patients who develop nosocomial infections due to extensively drug-resistant (XDR) Gram-negative bacilli. Ceftolozane/tazobactam (C/T) and ceftazidime/avibactam (CZA), which have activity against XDR Gram-negative bacteria, are two potential options. Data regarding the susceptibility of Burkholderia pseudomallei to these agents are limited, especially from Thailand, which is an endemic area for melioidosis.
A total of 28 B. pseudomallei isolates from melioidosis patients in northeast Thailand were tested for susceptibility to C/T and CZA by Etest and the disk diffusion method. Minimum inhibitory concentrations (MICs) for other antibiotics commonly used in melioidosis, including trimethoprim/sulfamethoxazole (SXT), ceftazidime (CAZ), imipenem (IPM) and meropenem, were also determined.
The MIC of C/T was very low for all isolates, ranging from 0.75 μg/mL to 1.0 μg/mL. For CZA, wide inhibitory zones ranging from 34-35 mm and MICs at 0.5 μg/mL were found. All isolates were also susceptible to SXT, CAZ and IPM based on Clinical and Laboratory Standards Institute (CLSI) breakpoints.
C/T and CZA exhibited excellent in vitro activity against B. pseudomallei. Further studies are required to prove efficacy in human subjects.
对于因广泛耐药（XDR）革兰氏阴性杆菌而发生医院感染的类鼻疽病患者，治疗选择有限。头孢他洛酯/他唑巴坦（C/T）和头孢他啶/阿维巴坦（CZA）对 XDR 革兰氏阴性菌具有活性，是两种潜在的选择。关于这些药物对伯克霍尔德氏菌敏感性的数据有限，特别是来自类鼻疽病流行地区的泰国。
对来自泰国东北部类鼻疽病患者的 28 株伯克霍尔德氏菌分离株进行 C/T 和 CZA 的药敏试验，采用 Etest 和纸片扩散法。还测定了其他常用于类鼻疽病的抗生素的最小抑菌浓度（MIC），包括复方磺胺甲噁唑（SXT）、头孢他啶（CAZ）、亚胺培南（IPM）和美罗培南。
所有分离株的 C/T MIC 均非常低，范围为 0.75 μg/mL 至 1.0 μg/mL。对于 CZA，发现抑菌圈范围很宽，为 34-35mm，MIC 为 0.5μg/mL。根据临床和实验室标准协会（CLSI）的临界点，所有分离株也对 SXT、CAZ 和 IPM 敏感。
C/T 和 CZA 对伯克霍尔德氏菌表现出极好的体外活性。需要进一步的研究来证明在人体中的疗效。
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