Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical Universitygrid.268099.c, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, Wenzhou, Zhejiang Province, China.
Department of Medical Lab Science, School of Laboratory Medicine and Life Science, Wenzhou Medical Universitygrid.268099.c, Wenzhou, Zhejiang Province, China.
J Clin Microbiol. 2022 Sep 21;60(9):e0000422. doi: 10.1128/jcm.00004-22. Epub 2022 Aug 10.
Ceftazidime-avibactam (CZA), a novel β-lactam/β-lactamase inhibitor combination, has good antibacterial activity against carbapenem-resistant (CRE) producing class A and C and some class D carbapenemases, but in recent years, the emergence of CZA-resistant bacteria is growing. Therefore, rapid, accurate, and timely detection of CZA is necessary for clinical anti-infection treatment. In this study, the rapid ResaCeftazidime-avibactam NP test was developed; its principle is that metabolically active bacteria (CZA-resistant strains) can change resazurin-PrestoBlue, a viability colorant, from blue to purple or pink in the presence of CZA, whereas CZA-susceptible strains cannot. We used 178 isolates to evaluate the performance of this test. This test allowed the susceptibility of to CZA to be detected within 4.5 h with an overall performance of 96% category agreement (CA), 7% major errors (MEs), and 0% very major errors (VMEs). Performance for Escherichia coli included 100% CA and 0% MEs and VMEs. Performance for Klebsiella pneumoniae included 99% CA and 2% MEs and 0% VMEs. Performance for Enterobacter cloacae included 87% CA, 25% MEs, and 0% VMEs. Moreover, this test is both economical ($1.0106 per isolate) and convenient, as it only requires basic laboratory equipment. In a word, the rapid ResaCeftazidime-avibactam NP test is rapid and feasible, which may provide certain backing for the rapid screening and timely treatment of CZA-resistant strains in the clinic.
头孢他啶-阿维巴坦(CZA)是一种新型β-内酰胺/β-内酰胺酶抑制剂合剂,对产碳青霉烯酶的 A 类和 C 类和一些 D 类碳青霉烯酶的耐药菌具有良好的抗菌活性,但近年来,CZA 耐药菌的出现呈增长趋势。因此,快速、准确、及时地检测 CZA 对于临床抗感染治疗是必要的。本研究开发了快速 ResaCeftazidime-avibactam NP 检测;其原理是,在 CZA 存在的情况下,代谢活跃的细菌(CZA 耐药株)可以将代谢指示剂 Resazurin-PrestoBlue 从蓝色变为紫色或粉红色,而 CZA 敏感株则不能。我们用 178 株分离株来评估该检测的性能。该检测可在 4.5 小时内检测出对 CZA 的敏感性,总体性能为 96%的类别一致性(CA)、7%的主要错误(MEs)和 0%的非常大错误(VMEs)。对大肠杆菌的检测性能为 100%CA 和 0%ME 和 VME。对肺炎克雷伯菌的检测性能为 99%CA 和 2%ME 和 0%VME。对阴沟肠杆菌的检测性能为 87%CA、25%ME 和 0%VME。此外,该检测既经济(每个分离株 1.0106 美元)又方便,因为它只需要基本的实验室设备。总之,快速 ResaCeftazidime-avibactam NP 检测快速可行,可为临床快速筛选和及时治疗 CZA 耐药株提供一定支持。