Rodríguez-Villodres Ángel, Lepe-Balsalobre Esperanza, Ortiz De La Rosa José Manuel, Giner Almaraz Salvador, González De Herrero Elisa, Cercenado Emilia, García-Fernández Sergio, Benito Rafael, Ponz Mir Ricardo, Cantón Rafael, Lepe José Antonio
Clinical Unit of Infectious Diseases, Microbiology and Parasitology, University Hospital Virgen del Rocío, Seville, Spain.
Institute of Biomedicine of Seville (IBiS), University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain.
JAC Antimicrob Resist. 2024 Jun 6;6(3):dlae087. doi: 10.1093/jacamr/dlae087. eCollection 2024 Jun.
To analyse the susceptibility profile to cefepime, carbapenems and new β-lactam/β-lactamase inhibitor combinations in complex and isolated from intra-abdominal, urinary, respiratory and bloodstream infections in the SMART (Study for Monitoring Antimicrobial Resistance Trends) surveillance study in Spain.
The susceptibilities of 759 isolates (473 complex and 286 ) collected in 11 Spanish hospitals from 2016 to 2022 were analysed following the EUCAST 2023 criteria. Molecular characterization looking for β-lactamase genes was performed through PCR and DNA sequencing analysis.
complex showed resistance to third-generation cephalosporins in 25% of the cases, whereas was resistant in 35%. Regarding cefepime, resistance in was higher (10%) than in (2%). Carbapenems showed >85% activity in both microorganisms. Ceftazidime/avibactam, imipenem/relebactam and meropenem/vaborbactam had good activity against these microorganisms (>95%). In contrast, the activity of ceftolozane/tazobactam was lower (80%). A high proportion of the isolates resistant to new β-lactam/β-lactamase inhibitor combinations carried a carbapenemase, mainly OXA-48-like and VIM-1.
Ceftazidime/avibactam, imipenem/relebactam and meropenem/vaborbactam show high activity against both complex and isolates recovered in the SMART-Spain study. In contrast, differences have been found in the case of cefepime, showing more activity against than complex. These results are useful for antimicrobial stewardship programmes and for the implementation of local and national guidelines.
在西班牙的SMART（监测抗菌药物耐药性趋势研究）监测研究中，分析从腹腔内、泌尿道、呼吸道和血流感染中分离出的复杂菌和单一菌对头孢吡肟、碳青霉烯类以及新型β-内酰胺/β-内酰胺酶抑制剂组合的药敏谱。
按照2023年欧盟CAST标准，分析了2016年至2022年在11家西班牙医院收集的759株分离菌（473株复杂菌和286株单一菌）的药敏情况。通过PCR和DNA测序分析进行寻找β-内酰胺酶基因的分子特征鉴定。
复杂菌在25%的病例中对第三代头孢菌素耐药，而单一菌的耐药率为35%。关于头孢吡肟，单一菌的耐药率（10%）高于复杂菌（2%）。碳青霉烯类在两种微生物中均显示出>85%的活性。头孢他啶/阿维巴坦、亚胺培南/瑞来巴坦和美罗培南/瓦博巴坦对这些微生物具有良好活性（>95%）。相比之下，头孢洛扎/他唑巴坦的活性较低（80%）。对新型β-内酰胺/β-内酰胺酶抑制剂组合耐药的分离菌中，很大一部分携带碳青霉烯酶，主要是OXA-48样酶和VIM-1。
头孢他啶/阿维巴坦、亚胺培南/瑞来巴坦和美罗培南/瓦博巴坦对SMART-西班牙研究中分离出的复杂菌和单一菌均显示出高活性。相比之下，在头孢吡肟的情况中发现了差异，其对单一菌的活性比对复杂菌更高。这些结果对抗菌药物管理计划以及地方和国家指南的实施很有用。
