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香港需氧及兼性厌氧革兰氏阴性杆菌的抗生素敏感性以及头孢他啶-阿维巴坦和头孢洛扎-他唑巴坦的有效性 implications

Antibiotic Susceptibility of Aerobic and Facultative Anaerobic Gram-Negative Rods in Hong Kong and Implications on Usefulness of Ceftazidime-Avibactam and Ceftolozane-Tazobactam.

作者信息

Teng Jade L L, Chan Elaine, Li Tsz Tuen, Kwan Tsz Ying, Chan Ka Fai, Li Wing Ho, Tang Viki W K, Yeung Man Lung, Lau Susanna K P, Woo Patrick C Y

机构信息

Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China.

Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.

出版信息

Antibiotics (Basel). 2024 Aug 24;13(9):802. doi: 10.3390/antibiotics13090802.

Abstract

Due to the increasing resistance of aerobic and facultative anaerobic Gram-negative rods, ceftazidime-avibactam and ceftolozane-tazobactam have been launched in the market in the last few years. In this study, we analyzed the susceptibility pattern of the major aerobic and facultative anaerobic Gram-negative rods in Hong Kong for ceftazidime-avibactam, ceftolozane-tazobactam, four other broad-spectrum antibiotics commonly used in Hong Kong and colistin. For 300 isolates collected from January to December 2021, non-ESBL-producing Enterobacterales, ESBL-producing Enterobacterales and were highly susceptible to ceftazidime-avibactam (all 100%) and ceftolozane-tazobactam (98.7%, 99.7% and 94.3%). For 32 archived ESBL-producing isolates collected between January 2014 and March 2023, all were susceptible to ceftazidime-avibactam and ceftolozane-tazobactam. For 101 archived carbapenemase-producing Enterobacterales, their susceptibilities to ceftazidime-avibactam and ceftolozane-tazobactam varied depending on the type of carbapenemase produced. Both had high activities against OXA-producing strains (97.1% and 76.5%, respectively) but were 100% resistant for NDM-producing and NDM+OXA-producing strains. All KPC-producing strains were susceptible to ceftazidime-avibactam but resistant to ceftolozane-tazobactam. Ceftazidime-avibactam and ceftolozane-tazobactam are good alternatives for the management of infections caused by ESBL-producing Enterobacterales and selective strains of carbapenemase-producing Enterobacterales in Hong Kong.

摘要

由于需氧和兼性厌氧革兰氏阴性杆菌的耐药性不断增加,头孢他啶-阿维巴坦和头孢洛扎-他唑巴坦在过去几年已投放市场。在本研究中,我们分析了香港主要需氧和兼性厌氧革兰氏阴性杆菌对头孢他啶-阿维巴坦、头孢洛扎-他唑巴坦、香港常用的其他四种广谱抗生素以及黏菌素的药敏模式。对于2021年1月至12月收集的300株分离株,非产超广谱β-内酰胺酶(ESBL)的肠杆菌科细菌、产ESBL的肠杆菌科细菌以及 对头孢他啶-阿维巴坦(均为100%)和头孢洛扎-他唑巴坦(分别为98.7%、99.7%和94.3%)高度敏感。对于2014年1月至2023年3月期间收集的32株存档的产ESBL分离株,所有菌株均对头孢他啶-阿维巴坦和头孢洛扎-他唑巴坦敏感。对于101株存档的产碳青霉烯酶肠杆菌科细菌,它们对头孢他啶-阿维巴坦和头孢洛扎-他唑巴坦的敏感性因所产碳青霉烯酶类型而异。两者对产OXA酶菌株均有较高活性(分别为97.1%和76.5%),但对产NDM酶和产NDM+OXA酶菌株的耐药率为100%。所有产KPC酶菌株对头孢他啶-阿维巴坦敏感,但对头孢洛扎-他唑巴坦耐药。在香港,头孢他啶-阿维巴坦和头孢洛扎-他唑巴坦是治疗产ESBL肠杆菌科细菌和部分产碳青霉烯酶肠杆菌科细菌所致感染的良好替代药物。

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