Department of Infectious Diseases and Clinical Microbiology, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul, Turkey.
Department of Medical Microbiology, Faculty of Medicine, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey.
Turk J Med Sci. 2022 Dec;52(6):1839-1844. doi: 10.55730/1300-0144.5530. Epub 2022 Dec 21.
Our study investigated the susceptibility rate of ceftazidime-avibactam and the risk factors associated with its resistance by analyzing gram-negative bacteria isolated from various patient samples.
Between March and November 2020, 1119 gram-negative bacteria strains were isolated from patient samples in Acıbadem Healthcare Group hospitals; ceftazidime-avibactam susceptibility results were evaluated using a 10/4µg (Oxoid, UK) disc and evaluated according to Eucast 2020 recommendations. Patient and isolate characteristics that could be risk factors were retrospectively investigated and statistically analyzed using SPSS 25.0.
Male patients made up 52% (n = 581) of the study's total patient population, and they averaged 55.5 ± 24.9 years old. Of 1119 gram-negative strains culture and antibiogram, 1023 (91.4%) were sensitive to ceftazidime-avibactam. An increased risk of resistance was observed with female gender (OR = 2.29; CI 95% [1.45-3.61]; p < 0.05), Pseudomonas aeruginosa (OR = 1.67, CI 95% [1.03-2.7]; p < 0.05), the presence of multidrug-resistance (MDR) (OR = 4.07, CI 95% [2.47-6.7]; p < 0.05) pandrug-resistance (PDR) (OR = 12, (CI) 95% [9.9-14.7] ]; p < 0.05) and admission to intensive care unit (ICU) (OR = 1.89, CI 95% [1.22-2.93]; p < 0.05).
The resistance rate of ceftazidime-avibactam was found to be 8.6%, and it was thought that resistant strains produced metallo-ß-lactamase (MBL) type carbapenemase. Risk factors were female gender, Pseudomonas aeruginosa, MDR, PDR, and admission to ICU. Therefore, studying the ceftazidime-avibactam susceptibility test together with gram-negative bacteria identification, especially in groups at risk for resistance, is one of the important factors that can positively affect the success of treatment.
本研究通过分析从各种患者样本中分离出的革兰氏阴性菌，调查了头孢他啶-阿维巴坦的敏感性率以及与其耐药性相关的危险因素。
2020 年 3 月至 11 月期间，从 Acıbadem Healthcare Group 医院的患者样本中分离出 1119 株革兰氏阴性菌；使用 10/4µg（Oxoid，英国）药敏纸片评估头孢他啶-阿维巴坦的药敏结果，并根据 Eucast 2020 建议进行评估。使用 SPSS 25.0 回顾性调查可能为危险因素的患者和分离株特征，并进行统计学分析。
研究总患者人群中男性占 52%（n=581），平均年龄为 55.5±24.9 岁。在 1119 株革兰氏阴性菌培养和药敏结果中，1023 株（91.4%）对头孢他啶-阿维巴坦敏感。女性（OR=2.29；95%CI[1.45-3.61]；p<0.05）、铜绿假单胞菌（OR=1.67，95%CI[1.03-2.7]；p<0.05）、多药耐药（MDR）（OR=4.07，95%CI[2.47-6.7]；p<0.05）和泛耐药（PDR）（OR=12，95%CI[9.9-14.7]；p<0.05）以及入住重症监护病房（ICU）（OR=1.89，95%CI[1.22-2.93]；p<0.05）与耐药风险增加相关。
头孢他啶-阿维巴坦的耐药率为 8.6%，认为耐药株产生金属-β-内酰胺酶（MBL）型碳青霉烯酶。危险因素为女性、铜绿假单胞菌、MDR、PDR 和入住 ICU。因此，在治疗中，与革兰氏阴性菌鉴定一起研究头孢他啶-阿维巴坦的药敏试验，特别是在有耐药风险的群体中，是积极影响治疗成功的重要因素之一。
