Bittencourt Amanda Azevedo, Faustino Vinicius Lima, Batista Paula de Mendonça, Leonel Lays Paulino, de Paula Marina Della Negra, Polis Thales José
Global Medical & Scientific Affairs (GMSA), MSD Brazil, São Paulo, SP, Brazil.
Global Medical & Scientific Affairs (GMSA), MSD Brazil, São Paulo, SP, Brazil.
Braz J Infect Dis. 2025 Jan-Feb;29(1):104497. doi: 10.1016/j.bjid.2024.104497. Epub 2024 Dec 12.
Increased spread of antimicrobial resistance by Gram-Negative Bacilli (GNB) poses a global challenge, with exacerbated burden post-pandemic. The aim of this study was to investigate the in vitro activity of ceftolozane/tazobactam and its comparators against the frequently identified GNB isolated from patients admitted to Brazilian medical sites between the year 2018‒2019 and 2020‒2021. The impact of pandemic on antimicrobial resistance and presence of β-lactamase genes were also evaluated. Antimicrobial susceptibility testing and molecular characterization of ß-lactamase encoding genes using Polymerase Chain Reaction (PCR) and DNA sequencing were carried out from GNB isolated mostly from intra-abdominal, respiratory, and urinary tract infections and interpreted following BrCAST/EUCAST guidelines. A total of 3994 GNB isolates were evaluated which mostly included E. coli, K. pneumoniae and P. aeruginosa. Ceftolozane/tazobactam remained highly active against E. coli isolates during both 2018‒2019 (96.0 %) and 2020‒2021 (98.5 %). Among K. pneumoniae, ceftolozane/tazobactam (47.6 % and 43.0 % susceptible during 2018‒2019 and 2020‒2021, respectively) showed poor activity due to bla. Colistin and ceftolozane/tazobactam were the most active β-lactam agents tested against P. aeruginosa in 2018‒2019 (99.3 % and 88.8 %) and 2020‒2021 (100 % and 92.8 %), including ceftazidime and meropenem resistant isolates. β-lactamase encoding gene characterization was carried out and both carbapenemases and Extended-Spectrum β-Lactamase (ESBL) producers were found in E. coli, K. pneumoniae and P. aeruginosa isolates. Ceftolozane/tazobactam documented remarkable in vitro activity against E. coli and P. aeruginosa isolates in Brazil, both pre- and post-pandemic periods and could constitute an effective therapeutic option for the treatment of urinary tract infections, intra-abdominal infections, and respiratory tract infections.
革兰氏阴性杆菌（GNB）导致的抗菌药物耐药性传播增加构成了一项全球性挑战，在疫情后负担更加沉重。本研究的目的是调查头孢洛扎/他唑巴坦及其对照药物对2018 - 2019年和2020 - 2021年期间从巴西医疗机构收治的患者中频繁分离出的GNB的体外活性。还评估了疫情对抗菌药物耐药性的影响以及β-内酰胺酶基因的存在情况。对主要从腹腔内、呼吸道和泌尿道感染中分离出的GNB进行了抗菌药物敏感性测试，并使用聚合酶链反应（PCR）和DNA测序对编码β-内酰胺酶的基因进行分子特征分析，结果按照BrCAST/EUCAST指南进行解读。共评估了3994株GNB分离株，其中主要包括大肠杆菌、肺炎克雷伯菌和铜绿假单胞菌。在2018 - 2019年（96.0%）和2020 - 2021年（98.5%）期间，头孢洛扎/他唑巴坦对大肠杆菌分离株均保持高活性。在肺炎克雷伯菌中，由于bla，头孢洛扎/他唑巴坦的活性较差（在2018 - 2019年和2020 - 2021年期间分别有47.6%和43.0%敏感）。在2018 - 2019年（99.3%和88.8%）和2020 - 2021年（100%和92.8%），包括对头孢他啶和美罗培南耐药的分离株，黏菌素和头孢洛扎/他唑巴坦是对铜绿假单胞菌测试的最具活性的β-内酰胺类药物。对编码β-内酰胺酶的基因进行了特征分析，在大肠杆菌、肺炎克雷伯菌和铜绿假单胞菌分离株中均发现了碳青霉烯酶和超广谱β-内酰胺酶（ESBL）产生菌。在巴西，无论疫情前还是疫情后，头孢洛扎/他唑巴坦对大肠杆菌和铜绿假单胞菌分离株均显示出显著的体外活性，可为治疗泌尿道感染、腹腔内感染和呼吸道感染构成有效的治疗选择。
