Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.
Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany.
Microb Drug Resist. 2022 May;28(5):545-550. doi: 10.1089/mdr.2021.0353. Epub 2022 May 5.
complex (Bcc) in airways of patients with cystic fibrosis (CF) is associated with an increased morbidity and mortality. A huge range of intrinsic antimicrobial resistances challenges the treatment of Bcc infections. The aim was to assess the susceptibility of Bcc to ceftazidime/avibactam and standard drugs for the treatment for CF patients and to determine the respective genomic determinants of resistance. Bcc isolates ( = 64) from a prospective multicenter study of CF airway pathogens (2004-2020, Germany) were subjected to broth microdilution and minimal inhibitory concentrations were interpreted with European Committee on Antimicrobial Susceptibility Testing and Clinical & Laboratory Standards Institute breakpoints. A synergism between aztreonam and avibactam was tested using ceftazidime/avibactam disks with or without aztreonam. Plasmids and chromosomes of all isolates were screened for antimicrobial resistance genes. The highest susceptibility rate was detected for trimethoprim/sulfamethoxazole (83%), followed by ceftazidime/avibactam (78%), ceftazidime (53%), levofloxacin (39%) and meropenem (27%). The median inhibition zone diameters of ceftazidime-avibactam and ceftazidime/avibactam plus aztreonam were equal. This was in line with the absence of known class B metallo-β-lactamases in any of the isolates. The majority of isolates carried (98%) and (86%). Trimethoprim/sulfamethoxazole and ceftazidime/avibactam showed high susceptibility rates. Aztreonam in combination with ceftazidime/avibactam had no synergistic effect in our Bcc isolates.
鲍曼不动杆菌（Bcc）在囊性纤维化（CF）患者的气道中存在与发病率和死亡率增加有关。广泛存在的固有抗微生物耐药性挑战了 Bcc 感染的治疗。目的是评估 Bcc 对头孢他啶/阿维巴坦和 CF 患者治疗标准药物的敏感性，并确定各自的耐药性基因组决定因素。从前瞻性 CF 气道病原体多中心研究（2004-2020 年，德国）中分离的 64 株 Bcc 分离株进行肉汤微量稀释，最小抑菌浓度（MIC）采用欧洲抗菌药物敏感性测试委员会（EUCAST）和临床与实验室标准协会（CLSI）折点进行解释。使用含有或不含有氨曲南的头孢他啶/阿维巴坦药敏纸片检测氨曲南与阿维巴坦之间的协同作用。所有分离株的质粒和染色体均进行了抗微生物药物耐药基因筛查。检测到的最高敏感性率为甲氧苄啶/磺胺甲恶唑（83%），其次为头孢他啶/阿维巴坦（78%）、头孢他啶（53%）、左氧氟沙星（39%）和美罗培南（27%）。头孢他啶-阿维巴坦和头孢他啶/阿维巴坦加氨曲南的抑菌圈直径中位数相等。这与任何分离株中均不存在已知的 B 类金属β-内酰胺酶相符。大多数分离株携带 （98%）和 （86%）。甲氧苄啶/磺胺甲恶唑和头孢他啶/阿维巴坦显示出较高的敏感性。氨曲南与头孢他啶/阿维巴坦联合使用在我们的 Bcc 分离株中没有协同作用。
