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新型头孢菌素/β-内酰胺酶抑制剂复方制剂应用于囊性纤维化患者后铜绿假单胞菌的耐药性。

Antimicrobial resistance of Pseudomonas aeruginosa in a cystic fibrosis population after introduction of a novel cephalosporin/β-lactamase inhibitor combination.

机构信息

Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.

Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark.

出版信息

APMIS. 2023 Aug;131(8):419-425. doi: 10.1111/apm.13331. Epub 2023 Jun 9.


DOI:10.1111/apm.13331
PMID:37294911
Abstract

Ceftolozane-tazobactam is a new β-lactam/β-lactamase inhibitor combination approved by the U.S. Food and Drug Administration in 2019 for the treatment of hospital-acquired and ventilator-associated pneumonia. The combination is a particularly potent inhibitor of penicillin-binding proteins with higher affinity than other β-lactam agents. Persons with cystic fibrosis (pwCF) often harbour resistant Gram-negative bacteria in the airways and need antibiotics to prevent declining lung function. To test whether the introduction of ceftolozane-tazobactam in the period 2015-2020 led to a bacterial population level increase in cephalosporin resistance in a Danish CF population. In vitro, activity of ceftolozane-tazobactam was evaluated by susceptibility testing of clinical Pseudomonas aeruginosa isolated from pwCF from January 1, 2015, to June 1, 2020. Six thousand three hundred thirty two isolates collected from 210 adult pwCF were included. Thirty pwCF were treated with ceftolozane-tazobactam at least once. Ceftolozane-tazobactam exposure did not increase cephalosporin resistance on an individual or population level. However, resistance to ceftolozane-tazobactam was recorded despite no prior exposure in four pwCF. Compared to ceftazidime, ceftolozane-tazobactam had a better in vitro activity on P. aeruginosa. The percentage of non-mucoid P. aeruginosa isolates susceptible to ceftolozane-tazobactam were higher or equal to 5 other β-lactams. Ceftolozane-tazobactam expands the armamentaria against P. aeruginosa with acceptable levels for a selection of drug resistance.

摘要

头孢洛扎他唑巴坦是一种新的β-内酰胺/β-内酰胺酶抑制剂组合,于 2019 年获得美国食品和药物管理局批准,用于治疗医院获得性和呼吸机相关性肺炎。该组合是青霉素结合蛋白的一种特别有效的抑制剂,其亲和力高于其他β-内酰胺药物。囊性纤维化(CF)患者的气道中经常存在耐药革兰氏阴性菌,需要使用抗生素来防止肺功能下降。为了测试 2015 年至 2020 年期间引入头孢洛扎他唑巴坦是否导致丹麦 CF 人群中头孢菌素耐药性的细菌群体水平增加。在体外,通过对 2015 年 1 月 1 日至 2020 年 6 月 1 日从 CF 患者中分离的临床铜绿假单胞菌进行药敏试验评估头孢洛扎他唑巴坦的活性。共收集了 210 名成年 CF 患者的 6332 株分离株。30 名 CF 患者至少接受过一次头孢洛扎他唑巴坦治疗。个体或人群水平的头孢菌素耐药性并未因头孢洛扎他唑巴坦暴露而增加。然而,尽管没有先前暴露,仍有 4 名 CF 患者记录到对头孢洛扎他唑巴坦的耐药性。与头孢他啶相比,头孢洛扎他唑巴坦对铜绿假单胞菌的体外活性更好。对头孢洛扎他唑巴坦敏感的非粘液铜绿假单胞菌分离株的百分比高于或等于其他 5 种β-内酰胺。头孢洛扎他唑巴坦扩大了针对铜绿假单胞菌的武器库,耐药性选择的耐药水平可接受。

相似文献

[1]
Antimicrobial resistance of Pseudomonas aeruginosa in a cystic fibrosis population after introduction of a novel cephalosporin/β-lactamase inhibitor combination.

APMIS. 2023-8

[2]
In-vitro activity of ceftolozane/tazobactam against Pseudomonas aeruginosa collected in the Study for Monitoring Antimicrobial Resistance Trends (SMART) between 2016 and 2019 in China.

Int J Antimicrob Agents. 2023-4

[3]
Ceftolozane/tazobactam activity against drug-resistant Enterobacteriaceae and Pseudomonas aeruginosa causing healthcare-associated infections in the Asia-Pacific region (minus China, Australia and New Zealand): report from an Antimicrobial Surveillance Programme (2013-2015).

Int J Antimicrob Agents. 2017-10-6

[4]
Phylogenetic analysis of resistance to ceftazidime/avibactam, ceftolozane/tazobactam and carbapenems in piperacillin/tazobactam-resistant Pseudomonas aeruginosa from cystic fibrosis patients.

Int J Antimicrob Agents. 2019-3-2

[5]
Comparative activity of newer β-lactam/β-lactamase inhibitor combinations against Pseudomonas aeruginosa isolates from US medical centres (2020-2021).

Int J Antimicrob Agents. 2023-4

[6]
Deciphering the Evolution of Cephalosporin Resistance to Ceftolozane-Tazobactam in Pseudomonas aeruginosa.

mBio. 2018-12-11

[7]
Activity of newest generation β-lactam/β-lactamase inhibitor combination therapies against multidrug resistant Pseudomonas aeruginosa.

Sci Rep. 2022-10-7

[8]
Activity of Ceftolozane-Tazobactam against Pseudomonas aeruginosa and Enterobacteriaceae Isolates Collected from Respiratory Tract Specimens of Hospitalized Patients in the United States during 2013 to 2015.

Antimicrob Agents Chemother. 2018-2-23

[9]
In vitro antimicrobial activity of ceftolozane/tazobactam against Pseudomonas aeruginosa and other non-fermenting Gram-negative bacteria in adults with cystic fibrosis.

J Glob Antimicrob Resist. 2018-3-17

[10]
Comparison of Ceftolozane-Tazobactam to Traditional Beta-Lactams and Ceftolozane-Tazobactam as an Alternative to Combination Antimicrobial Therapy for Pseudomonas aeruginosa.

Antimicrob Agents Chemother. 2017-11-22

引用本文的文献

[1]
Ceftolozane/Tazobactam for the Treatment of Adults With Cystic Fibrosis: Results From a French Prospective Cohort Study.

Open Forum Infect Dis. 2024-8-6

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