Wang Yifan, Li Yanjun, Zhao Jin, Guan Jie, Ni Wentao, Gao Zhancheng
Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, China.
Clinical Laboratory, The Sixth Medical Center of PLA General Hospital, Beijing, China.
Ann Transl Med. 2022 Mar;10(5):261. doi: 10.21037/atm-22-889.
Cefiderocol is a promising antimicrobial agent against carbapenem-resistant, Gram-negative bacteria, but susceptibility data from the Chinese mainland are lacking. The aim of the present study was to test the susceptibility of cefiderocol against carbapenem-resistant, Gram-negative bacteria collected from Beijing, China.
Carbapenem-resistant (CR-KP; n=105), carbapenem-resistant (CR-AB; n=126), carbapenem-resistant (CR-PA; n=74), and (SM; n=72) isolates were collected from inpatients at 4 tertiary hospitals in Beijing, China. Minimum inhibitory concentrations (MICs) for cefiderocol were determined using iron-depleted cation-adjusted Mueller Hinton broth (CAMHB), and for comparators using CAMHB, according to the recommended Clinical and Laboratory Standards Institute (CLSI) methodology. Carbapenemase and other β-lactamase gene profiles were determined using polymerase chain reaction (PCR).
Cefiderocol inhibited 100% of CR-KP and CR-PA, and 98.6% of the SM isolates at the susceptibility breakpoint concentration of 4 mg/L. However, the susceptibility rate for cefiderocol against CR-AB was only 62.7%, with MIC values as high as 128 mg/L. Nearly all the cefiderocol-susceptible CR-AB isolates were found to be positive for and , whereas all the cefiderocol-resistant CR-AB isolates were found to be positive for the genes, in addition to and .
Cefiderocol showed potent activity against CR-KP, CR-PA, and SM isolates collected from Beijing, China. However, the resistance rate for cefiderocol against CR-AB was higher than that reported by other research centers, and the presence of might contribute to resistance in non-susceptible CR-AB isolates.
头孢地尔是一种有前景的抗碳青霉烯类耐药革兰氏阴性菌的抗菌药物，但中国大陆地区缺乏其药敏数据。本研究的目的是检测头孢地尔对从中国北京收集的碳青霉烯类耐药革兰氏阴性菌的敏感性。
从中国北京4家三级医院的住院患者中收集耐碳青霉烯类肺炎克雷伯菌（CR-KP；n = 105）、耐碳青霉烯类鲍曼不动杆菌（CR-AB；n = 126）、耐碳青霉烯类铜绿假单胞菌（CR-PA；n = 74）和嗜麦芽窄食单胞菌（SM；n = 72）分离株。根据推荐的临床和实验室标准协会（CLSI）方法，使用缺铁阳离子调整的穆勒-欣顿肉汤（CAMHB）测定头孢地尔的最低抑菌浓度（MIC），使用CAMHB测定对照药物的MIC。使用聚合酶链反应（PCR）测定碳青霉烯酶和其他β-内酰胺酶基因谱。
在药敏折点浓度4 mg/L时，头孢地尔对100%的CR-KP和CR-PA以及98.6%的SM分离株有抑制作用。然而，头孢地尔对CR-AB的敏感率仅为62.7%，MIC值高达128 mg/L。几乎所有对头孢地尔敏感的CR-AB分离株检测bla OXA-23和bla OXA-51呈阳性，而所有对头孢地尔耐药的CR-AB分离株除bla OXA-23和bla OXA-51外，bla OXA-24/40基因也呈阳性。
头孢地尔对从中国北京收集的CR-KP、CR-PA和SM分离株显示出强大的活性。然而，头孢地尔对CR-AB的耐药率高于其他研究中心报道的耐药率，bla OXA-24/40的存在可能导致非敏感CR-AB分离株产生耐药性。
