Lu Jiayue, Qing Yan, Dong Ning, Liu Congcong, Zeng Yu, Sun Qiaoling, Shentu Qiao, Huang Lixing, Wu Yingqian, Zhou Hongwei, Shen Zhangqi, Zhang Rong
Department of Clinical Laboratory, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong.
Saudi Pharm J. 2022 Jun;30(6):849-855. doi: 10.1016/j.jsps.2022.03.007. Epub 2022 Mar 14.
The emergence of carbapenem-resistant organisms posed considerable threat to global health while only limited treatment options are available and led to efforts to discover a novel way to treat them. To evaluate synergistic activity of meropenem plus ertapenem, a total of 203 carbapenem-resistant strains, collected from 12 provinces and municipalities in China, were examined with a dual carbapenem combination therapy. The statistical software R was used for analysis. Two hundred and one (201) of carbapenem-resistant strains mainly produced four types of carbapenemase: KPC-2 (n = 142, 69.95%), OXA-232 (n = 7, 3.45%), NDM (n = 38, 18.72%; 36 NDM-1, 1 NDM-4, 1 NDM-5), and IMP (n = 15, 7.39%; 1 IMP-26, 10 IMP-30, 4 IMP-4). Fifty-one out of two hundred and three (51/203 or 25.12%) of the examined strains showed a synergistic effect for the meropenem plus ertapenem combination throughout the checkerboard method, while only three isolates showed potential clinically relevant synergy (3/203, 1.48%). An additive effect was observed in 55/203 (27.09%) of the examined strains. Ninety-seven of the examined isolates (47.78%) showed fractional inhibitory concentration (FIC) greater or equal to 2 (indicating antagonism). The synergistic activity of meropenem plus ertapenem combination suggests this combination can be a possible way to treat the infection caused by the carbapenem-resistant organisms, especially for IMP or NDM producer with a lesser minimum inhibitory concentration (MIC) and the infected individual who was not recommended to use colistin or tigecycline.
碳青霉烯类耐药菌的出现对全球健康构成了相当大的威胁，而针对它们的治疗选择有限，这促使人们努力寻找新的治疗方法。为了评估美罗培南联合厄他培南的协同活性，采用双碳青霉烯联合疗法对从中国12个省市收集的203株碳青霉烯类耐药菌株进行了检测。使用统计软件R进行分析。201株碳青霉烯类耐药菌株主要产生四种类型的碳青霉烯酶：KPC-2（n = 142，69.95%）、OXA-232（n = 7，3.45%）、NDM（n = 38，18.72%；36株NDM-1、1株NDM-4、1株NDM-5）和IMP（n = 15，7.39%；1株IMP-26、10株IMP-30、4株IMP-4）。在203株检测菌株中，有51株（51/203或25.12%）通过棋盘法显示美罗培南联合厄他培南具有协同作用，而只有3株分离株显示出潜在的临床相关协同作用（3/203，1.48%）。在55/203（27.09%）的检测菌株中观察到相加作用。97株检测分离株（47.78%）的分数抑菌浓度（FIC）大于或等于2（表明拮抗作用）。美罗培南联合厄他培南的协同活性表明，这种联合用药可能是治疗碳青霉烯类耐药菌感染的一种方法，特别是对于最低抑菌浓度（MIC）较低的IMP或NDM产生菌以及不建议使用黏菌素或替加环素的感染个体。
