Zins Charlie, Pailhoriès Hélène, Chenouard Rachel, Corvec Stéphane, Dahyot Sandrine, Woerther Paul-Louis, Eckert Catherine, Pierrat Gautier, Bourge Xavier, Boyer Sophie, Kempf Marie
Département de Biologie des Agents Infectieux, UF de Bactériologie-Hygiène, Centre Hospitalier Universitaire Angers, France.
Département de Biologie des Agents Infectieux, UF de Bactériologie-Hygiène, Centre Hospitalier Universitaire Angers, France; HIFIH Laboratoire UPRES EA3859, SFR ICAT 4208 Université Angers, Angers, France.
Infect Dis Now. 2025 Jun;55(4):105056. doi: 10.1016/j.idnow.2025.105056. Epub 2025 Mar 13.
To assess the susceptibility of ceftolozane/tazobactam (C/T) and comparators to Pseudomonas aeruginosa isolates recovered from respiratory-tract-infections (RTI) between 2016-2022 in the French SMART study.
Antibiotic susceptibility testing and minimum inhibitory concentrations (MICs) of 717 P.aeruginosa isolates collected in five French hospitals were determined and interpreted according to the EUCAST-2022 guidelines. P. aeruginosa isolates resistant (R) to imipenem and/or C/T were screened by PCR for extended-spectrum-β-lactamases (ESBLs), AmpC and carbapenemase genes. The identified genes were sequenced and the variants determined.
All in all, 96.5 % of P. aeruginosa isolates were susceptible to C/T, comparable to the susceptibilities of meropenem-vaborbactam (MVB = 96.5 %), imipenem/relebactam (IMI/REL = 96.9 %) and ceftazidime-avibactam (C/A = 97.0 %). MIC and MIC for C/T were 0.5 and 2 mg/L respectively against the 717 isolates. Among the 242 isolates (33.7 %) resistant to at least one anti-Pseudomonas β-lactam, close to 90 % were susceptible to C/T, C/A, MVB and IMI/REL. Among the 80 isolates resistant to piperacillin-tazobactam, cefepime and ceftazidime, 76.3 % were susceptible to C/T and only IMI/REL and amikacin reached susceptibility exceeding 80 %. Among the 32 isolates resistant to imipenem and meropenem, susceptibility exceeding 60 % was observed only for IMI/REL, C/T, and C/A. For these strains, the MIC of C/T was 2 mg/L, while that of C/A was at the resistance threshold (8 mg/L). IMI/REL had the strongest activity (72 %) against the 25 isolates resistant to C/T. Lastly, 53 imipenem and/or C/T-R isolates harbored a class C β-lactam (blaPDC) variant, and one of them also carried the bla gene and another, the bla gene.
C/T is a reliable treatment option in RTI caused by P. aeruginosa.
在法国的SMART研究中，评估头孢洛扎/他唑巴坦（C/T）及对照药物对2016年至2022年间从呼吸道感染（RTI）患者中分离出的铜绿假单胞菌的敏感性。
根据欧盟CAST-2022指南，对从法国五家医院收集的717株铜绿假单胞菌进行抗生素敏感性测试和最低抑菌浓度（MIC）测定及结果判读。对亚胺培南和/或C/T耐药（R）的铜绿假单胞菌分离株通过PCR检测超广谱β-内酰胺酶（ESBLs）、AmpC和碳青霉烯酶基因。对鉴定出的基因进行测序并确定变异情况。
总体而言，96.5%的铜绿假单胞菌分离株对C/T敏感，与美罗培南-巴罗巴坦（MVB = 96.5%）、亚胺培南/瑞来巴坦（IMI/REL = 96.9%）和头孢他啶-阿维巴坦（C/A = 97.0%）的敏感性相当。针对这717株分离株，C/T的MIC和MIC分别为0.5和2mg/L。在对至少一种抗假单胞菌β-内酰胺耐药的242株分离株（33.7%）中，近90%对C/T、C/A、MVB和IMI/REL敏感。在对哌拉西林-他唑巴坦、头孢吡肟和头孢他啶耐药的80株分离株中，76.3%对C/T敏感，只有IMI/REL和阿米卡星的敏感性超过80%。在对亚胺培南和美罗培南耐药的32株分离株中，仅IMI/REL、C/T和C/A的敏感性超过60%。对于这些菌株，C/T的MIC为2mg/L,而C/A的MIC处于耐药阈值（8mg/L）。IMI/REL对25株对C/T耐药的分离株活性最强（72%）。最后，53株亚胺培南和/或C/T耐药分离株携带C类β-内酰胺（blaPDC）变异体，其中一株还携带bla基因，另一株携带bla基因。
C/T是治疗铜绿假单胞菌引起的RTI的可靠治疗选择。
