病例评论：头孢吡肟/齐多夫定（WCK 5222）作为挽救疗法成功治疗成人急性 T 细胞白血病伴广泛耐药新德里金属β-内酰胺酶产 感染播散
Case Commentary: Successful Use of Cefepime/Zidebactam (WCK 5222) as a Salvage Therapy for the Treatment of Disseminated Extensively Drug-Resistant New Delhi Metallo-β-Lactamase-Producing Infection in an Adult Patient with Acute T-Cell Leukemia.
机构信息
Division of Infectious Diseases, Department of Internal Medicine, Houston Methodist Hospital, Houston, Texas, USA.
Division of Infectious Diseases, Department of Internal Medicine, Oregon Health and Science University, Portland, Oregon, USA.
出版信息
Antimicrob Agents Chemother. 2023 Aug 17;67(8):e0066323. doi: 10.1128/aac.00663-23. Epub 2023 Jul 3.
Abstract
Multidrug-resistant/extensively drug-resistant (MDR/XDR) Pseudomonas aeruginosa (PA) are critical antimicrobial resistance threats. Despite their increasing prevalence, treatment options for metallo-β-lactamase (MBL)-producing PA are limited, especially for New Delhi metallo-β-lactamase (NDM) producers. Pending further clinical studies, this case provides support for limited-scope use of cefepime-zidebactam for treating disseminated infections secondary to NDM-producing XDR PA. Susceptibilities should be tested and/or alternative regimens considered when treating isolates with alternative MBLs or increased efflux pump expression because some data suggest associated loss of cefepime-zidebactam susceptibility.
摘要
多药耐药/广泛耐药（MDR/XDR）铜绿假单胞菌（PA）是严重的抗微生物药物耐药威胁。尽管其流行率不断增加，但对于产金属β-内酰胺酶（MBL）的 PA 的治疗选择有限，尤其是对于新德里金属β-内酰胺酶（NDM）产生菌。在进一步的临床研究之前，本病例为有限使用头孢吡肟-他唑巴坦治疗由产 NDM 的 XDR-PA 引起的播散性感染提供了支持。在治疗具有其他 MBL 或增加外排泵表达的分离株时，应进行药敏试验和/或考虑替代方案，因为一些数据表明与头孢吡肟-他唑巴坦的敏感性相关的丧失。
相似文献
1
Case Commentary: Successful Use of Cefepime/Zidebactam (WCK 5222) as a Salvage Therapy for the Treatment of Disseminated Extensively Drug-Resistant New Delhi Metallo-β-Lactamase-Producing Infection in an Adult Patient with Acute T-Cell Leukemia.病例评论：头孢吡肟/齐多夫定（WCK 5222）作为挽救疗法成功治疗成人急性 T 细胞白血病伴广泛耐药新德里金属β-内酰胺酶产 感染播散
Antimicrob Agents Chemother. 2023 Aug 17;67(8):e0066323. doi: 10.1128/aac.00663-23. Epub 2023 Jul 3.
2
Successful Use of Cefepime-Zidebactam (WCK 5222) as a Salvage Therapy for the Treatment of Disseminated Extensively Drug-Resistant New Delhi Metallo-β-Lactamase-Producing Pseudomonas aeruginosa Infection in an Adult Patient with Acute T-Cell Leukemia.成功使用头孢吡肟-齐多夫定（WCK 5222）作为挽救疗法治疗急性 T 细胞白血病成年患者广泛耐药新德里金属β-内酰胺酶产生铜绿假单胞菌感染的播散性感染。
Antimicrob Agents Chemother. 2023 Aug;67(8):e0050023. doi: 10.1128/aac.00500-23. Epub 2023 Jun 14.
3
Compassionate use of a novel β-lactam enhancer-based investigational antibiotic cefepime/zidebactam (WCK 5222) for the treatment of extensively-drug-resistant NDM-expressing Pseudomonas aeruginosa infection in an intra-abdominal infection-induced sepsis patient: a case report.新型β-内酰胺酶增强剂研究用抗生素头孢吡肟/齐他培南（WCK 5222）治疗产 NDM 广泛耐药铜绿假单胞菌感染所致腹腔感染相关性脓毒症患者的同情用药：一例报告。
Ann Clin Microbiol Antimicrob. 2023 Jul 5;22(1):55. doi: 10.1186/s12941-023-00606-x.
4
Molecular Characterization of WCK 5222 (Cefepime/Zidebactam)-Resistant Mutants Developed from a Carbapenem-Resistant Pseudomonas aeruginosa Clinical Isolate.从一株耐碳青霉烯铜绿假单胞菌临床分离株中筛选出对 WCK 5222（头孢吡肟/齐他培南）耐药的突变株，并对其进行分子特征分析。
Microbiol Spectr. 2022 Feb 23;10(1):e0267821. doi: 10.1128/spectrum.02678-21.
5
WCK 5222 (cefepime/zidebactam) antimicrobial activity tested against Gram-negative organisms producing clinically relevant β-lactamases.WCK 5222（头孢吡肟/齐地卡南）针对产生具有临床相关性β-内酰胺酶的革兰氏阴性菌的抗菌活性测试。
J Antimicrob Chemother. 2017 Jun 1;72(6):1696-1703. doi: 10.1093/jac/dkx050.
6
Efficacy of human-simulated bronchopulmonary exposures of cefepime, zidebactam and the combination (WCK 5222) against MDR Pseudomonas aeruginosa in a neutropenic murine pneumonia model.头孢吡肟、齐多夫定和联合制剂（WCK 5222）在中性粒细胞减少性肺炎小鼠模型中对耐多药铜绿假单胞菌的人模拟支气管肺部暴露的疗效。
J Antimicrob Chemother. 2020 Jan 1;75(1):149-155. doi: 10.1093/jac/dkz414.
7
WCK 5222 (Cefepime-Zidebactam) Antimicrobial Activity against Clinical Isolates of Gram-Negative Bacteria Collected Worldwide in 2015.WCK 5222（头孢吡肟-齐地巴坦）对2015年全球收集的革兰氏阴性菌临床分离株的抗菌活性。
Antimicrob Agents Chemother. 2017 Apr 24;61(5). doi: 10.1128/AAC.00072-17. Print 2017 May.
8
Activity of WCK 5222 (Cefepime-Zidebactam) against Worldwide Collected Gram-Negative Bacilli Not Susceptible to Carbapenems.WCK 5222（头孢吡肟-齐德巴坦）对全球收集的对碳青霉烯类不敏感的革兰氏阴性杆菌的活性。
Antimicrob Agents Chemother. 2020 Nov 17;64(12). doi: 10.1128/AAC.01432-20.
9
WCK 5107 (Zidebactam) and WCK 5153 Are Novel Inhibitors of PBP2 Showing Potent "β-Lactam Enhancer" Activity against Pseudomonas aeruginosa, Including Multidrug-Resistant Metallo-β-Lactamase-Producing High-Risk Clones.WCK 5107（齐德巴坦）和WCK 5153是新型PBP2抑制剂，对铜绿假单胞菌表现出强大的“β-内酰胺增强剂”活性，包括产多重耐药金属β-内酰胺酶的高风险克隆株。
Antimicrob Agents Chemother. 2017 May 24;61(6). doi: 10.1128/AAC.02529-16. Print 2017 Jun.
10
Activity of cefepime/zidebactam (WCK 5222) against 'problem' antibiotic-resistant Gram-negative bacteria sent to a national reference laboratory.头孢吡肟/齐多夫定（WCK 5222）对送往国家参考实验室的“问题”抗生素耐药革兰氏阴性菌的活性。
J Antimicrob Chemother. 2021 May 12;76(6):1511-1522. doi: 10.1093/jac/dkab067.
引用本文的文献
1
7--Carboxylic Acid-Substituted 3--Alkyl Difluoroquercetin; An Aztreonam-Potentiating Agent Against Carbapenemase-Producing Through Simultaneous Inhibition of Metallo-β-Lactamase and Efflux Pump.7-羧酸取代的3-烷基二氟槲皮素；一种通过同时抑制金属β-内酰胺酶和外排泵来增强氨曲南对产碳青霉烯酶菌活性的药物。
Antibiotics (Basel). 2024 Dec 10;13(12):1202. doi: 10.3390/antibiotics13121202.
本文引用的文献
1
Potential of Inaccurate Cefiderocol Susceptibility Results: a CLSI AST Subcommittee Advisory.头孢地尔药敏结果不准确的可能性：CLSI抗菌药物敏感性试验分委员会的建议
J Clin Microbiol. 2023 Apr 20;61(4):e0160022. doi: 10.1128/jcm.01600-22. Epub 2023 Mar 22.
2
In vitro activity of cefepime/zidebactam and cefepime/taniborbactam against aztreonam/avibactam-resistant NDM-like-producing Escherichia coli clinical isolates.头孢吡肟/齐他培南和头孢吡肟/替加环素对产 NDM 样酶超广谱β-内酰胺酶大肠埃希菌临床分离株的体外活性。
J Antimicrob Chemother. 2023 May 3;78(5):1191-1194. doi: 10.1093/jac/dkad061.
3
Antimicrobial Activity of Ceftolozane-Tazobactam, Ceftazidime-Avibactam, and Cefiderocol against Multidrug-Resistant Pseudomonas aeruginosa Recovered at a German University Hospital.头孢洛扎他唑巴坦、头孢他啶-阿维巴坦和头孢地尔在德国一所大学医院分离的多重耐药铜绿假单胞菌中的抗菌活性。
Microbiol Spectr. 2022 Oct 26;10(5):e0169722. doi: 10.1128/spectrum.01697-22. Epub 2022 Oct 3.
4
Activity of cefiderocol, imipenem/relebactam, cefepime/taniborbactam and cefepime/zidebactam against ceftolozane/tazobactam- and ceftazidime/avibactam-resistant Pseudomonas aeruginosa.头孢地尔肟、亚胺培南/雷巴他定、头孢吡肟/他唑巴坦和头孢吡肟/齐多夫定对头孢他啶/他唑巴坦和头孢噻肟/阿维巴坦耐药铜绿假单胞菌的活性。
J Antimicrob Chemother. 2022 Sep 30;77(10):2809-2815. doi: 10.1093/jac/dkac241.
5
Antimicrobial activity of cefepime/zidebactam (WCK 5222), a β-lactam/β-lactam enhancer combination, against clinical isolates of Gram-negative bacteria collected worldwide (2018-19).头孢吡肟/齐他培南（WCK 5222），一种β-内酰胺/β-内酰胺增强剂组合，对全球范围内收集的革兰氏阴性菌临床分离株的抗菌活性（2018-19 年）。
J Antimicrob Chemother. 2022 Sep 30;77(10):2642-2649. doi: 10.1093/jac/dkac233.
6
Activity of New β-Lactam-β-Lactamase Inhibitor Combinations and Comparators against Clinical Isolates of Gram-Negative Bacilli: Results from the China Antimicrobial Surveillance Network (CHINET) in 2019.2019 年中国细菌耐药监测网（CHINET）研究：新型β-内酰胺类-β-内酰胺酶抑制剂复方制剂及对照药物对革兰阴性杆菌临床分离株的活性。
Microbiol Spectr. 2022 Aug 31;10(4):e0185422. doi: 10.1128/spectrum.01854-22. Epub 2022 Jul 12.
7
New Delhi Metallo-Beta-Lactamase Facilitates the Emergence of Cefiderocol Resistance in Enterobacter cloacae.新德里金属-β-内酰胺酶促进阴沟肠杆菌对头孢地尔罗耐药的产生。
Antimicrob Agents Chemother. 2022 Feb 15;66(2):e0201121. doi: 10.1128/AAC.02011-21. Epub 2021 Dec 6.
8
Cefiderocol Activity Against Clinical Isolates Exhibiting Ceftolozane-Tazobactam Resistance.头孢地尔对表现出对头孢洛扎坦-他唑巴坦耐药的临床分离株的活性。
Open Forum Infect Dis. 2021 Jun 12;8(7):ofab311. doi: 10.1093/ofid/ofab311. eCollection 2021 Jul.
9
An Update on Eight "New" Antibiotics against Multidrug-Resistant Gram-Negative Bacteria.针对多重耐药革兰氏阴性菌的八种“新型”抗生素的最新情况
J Clin Med. 2021 Mar 4;10(5):1068. doi: 10.3390/jcm10051068.
10
Evolution of Cefiderocol Non-Susceptibility in Pseudomonas aeruginosa in a Patient Without Previous Exposure to the Antibiotic.铜绿假单胞菌对头孢地尔罗耐药性的演变：一位既往未使用过该抗生素患者的病例报告。
Clin Infect Dis. 2021 Dec 6;73(11):e4472-e4474. doi: 10.1093/cid/ciaa1909.
Zotero 插件