Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, People's Republic of China.
Graduate school, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
BMC Microbiol. 2022 Oct 1;22(1):234. doi: 10.1186/s12866-022-02644-5.
Data on antibiotic resistance is essential to adapt treatment strategies against the rapidly changing reality of antimicrobial resistance.
To study the in vitro activity of ceftaroline, ceftazidime-avibactam, and comparators against Gram-positive and Gram-negative bacteria collected from China in the year 2018.
A total of 2301 clinical isolates were collected from 17 medical center laboratories in China, which participated in the ATLAS program in 2018. Antimicrobial susceptibilities were determined by the broth microdilution method at a central laboratory. Clinical and Laboratory Standards Institute (CLSI) breakpoints were used to interpret the results except for tigecycline, for which the US Food and Drug Administration (FDA) breakpoint were used.
The susceptibility rates of methicillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant Streptococcus pneumoniae (PRSP), and β-hemolytic streptococcus to ceftaroline were 83.9%, 100%, and 100%, respectively. Escherichia coli, imipenem-susceptible (IMP-S) Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, IMP-S Enterobacter cloacae, Proteus mirabilis, Morganella morganii, Serratia marcescens and Pseudomonas aeruginosa had high susceptibility rates to ceftazidime-avibactam (95.8%, 100%, 97.7%, 94.5%, 100%, 90.2%, 96.0%, 97.5% and 90.7%, respectively). However, imipenem-resistant Escherichia coli and imipenem-resistant Pseudomonas aeruginosa demonstrated low susceptibility to ceftazidime-avibactam (33.3% and 75.8%, respectively). Against MRSA, methicillin-susceptible Staphylococcus aureus (MSSA), S. pneumoniae and β-hemolytic streptococci, the susceptibility rates of tigecycline were 93.5%, 99.2%, 100% and 100%, respectively. Levofloxacin also showed high in vitro activity against S. pneumoniae and β-hemolytic streptococci with a susceptibility rate of 100% and 98.4%. The susceptibility rate of E. faecalis to ampicillin was 100%. Among Gram-negative isolates, tigecycline and colistin showed good activity against E. coli, K. pneumoniae, imipenem-resistant E. cloacae, C. freundii and A. baumannii (susceptibility rates and intermediate susceptibility rates of 99.3% and 96.8%, 95.4% and 94.5%, 100% and 87.5%, 96.4% and 89.3%, MIC of 2 mg/L and 97.4%, respectively). E. coli and E. cloacae had high susceptibility rates to imipenem and meropenem (93.0% and 92.8%, 89.8% and 92.1%, respectively). M. morganii and P. mirabilis demonstrated meropenem and piperacillin-tazobactam susceptibility rates of 96.0% and 94.0%, 94.1% and 92.2%, respectively.
Ceftaroline showed good activity among tested antimicrobial agents against Gram-positive species, while ceftazidime-avibactam had good activity against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Morganella morganii, Serratia marcescens and Pseudomonas aeruginosa excluding carbapenem-resistant isolates.
抗生素耐药数据对于针对抗菌药物耐药性快速变化的现实调整治疗策略至关重要。
研究头孢洛林、头孢他啶-阿维巴坦和对照药物对 2018 年中国分离的革兰阳性和革兰阴性细菌的体外活性。
共收集了 2301 株临床分离株，来自中国 17 家医学中心实验室，这些实验室参加了 2018 年的 ATLAS 项目。在中央实验室采用肉汤微量稀释法测定抗菌药物敏感性。除替加环素外，采用临床和实验室标准协会（CLSI）折点解释结果，替加环素采用美国食品和药物管理局（FDA）折点。
耐甲氧西林金黄色葡萄球菌（MRSA）、青霉素耐药肺炎链球菌（PRSP）和β-溶血性链球菌对头孢洛林的敏感性率分别为 83.9%、100%和 100%。大肠杆菌、亚胺培南敏感的大肠杆菌（IMP-S）、肺炎克雷伯菌、阴沟肠杆菌、IMP-S 阴沟肠杆菌、奇异变形杆菌、摩氏摩根菌、粘质沙雷氏菌和铜绿假单胞菌对头孢他啶-阿维巴坦的敏感性率均较高（95.8%、100%、97.7%、94.5%、100%、90.2%、96.0%、97.5%和 90.7%）。然而，亚胺培南耐药的大肠杆菌和亚胺培南耐药的铜绿假单胞菌对头孢他啶-阿维巴坦的敏感性较低（分别为 33.3%和 75.8%）。头孢洛林对 MRSA、甲氧西林敏感的金黄色葡萄球菌（MSSA）、肺炎链球菌和β-溶血性链球菌的敏感性率分别为 93.5%、99.2%、100%和 100%。左氧氟沙星对肺炎链球菌和β-溶血性链球菌也表现出高度的体外活性，敏感性率为 100%和 98.4%。粪肠球菌对氨苄西林的敏感性率为 100%。在革兰氏阴性分离株中，替加环素和粘菌素对大肠杆菌、肺炎克雷伯菌、亚胺培南耐药的阴沟肠杆菌、弗劳地柠檬酸杆菌和鲍曼不动杆菌（敏感性率和中介敏感性率分别为 99.3%和 96.8%、95.4%和 94.5%、100%和 87.5%、96.4%和 89.3%，MIC 为 2mg/L 和 97.4%）表现出良好的活性。大肠杆菌和阴沟肠杆菌对亚胺培南和美罗培南的敏感性率分别为 93.0%和 92.8%、89.8%和 92.1%。摩根摩根菌和奇异变形杆菌对美罗培南和哌拉西林-他唑巴坦的敏感性率分别为 96.0%和 94.0%、94.1%和 92.2%。
头孢洛林对测试的抗革兰阳性菌药物显示出良好的活性，而头孢他啶-阿维巴坦对大肠杆菌、肺炎克雷伯菌、阴沟肠杆菌、奇异变形杆菌、摩根摩根菌、粘质沙雷氏菌和铜绿假单胞菌具有良好的活性，不包括碳青霉烯类耐药分离株。
