Chang Jianliang, Peng Xiaocui, Wang Xue, Zhang Zhihua
Graduate School of Hebei North University, Zhangjiakou, Hebei, 075000, People's Republic of China.
Respiratory and Critical Care Medicine Department, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, 075000, People's Republic of China.
Infect Drug Resist. 2025 Apr 26;18:2137-2152. doi: 10.2147/IDR.S515858. eCollection 2025.
To study the resistance of carbapenem-resistant to β-lactams combined with avibactam, as well as the distribution of resistance and virulence genes, and to analyze the clinical characteristics of infected patients.
Antibiotic susceptibility was examined using the trace broth dilution method. Carbapenem-resistance genes, porins, and virulence genes were identified using PCR. Strain adhesion was assessed through wire-drawing experiments, and clinical data from infected patients were collected.
Among 80 CRKP strains, 93.8% harboured KPC-2, and 1.3% harboured both KPC-2 and NDM. Some strains lacked OMPK35 (6.2%) and OMPK36 (10%). Virulence genes , and were prevalent. The combination of carbapenems, cephalosporins, and aztreonam with avibactam significantly lowered MIC values compared to single drugs (P<0.01). Significant differences in MIC were noted between low and high avibactam concentrations (P<0.05).
CRKP harbouring virulence genes poses significant risks. Combining carbapenems, cephalosporins, and avibactam enhances antibacterial activity against CRKP.
研究耐碳青霉烯类肺炎克雷伯菌对β-内酰胺类与阿维巴坦联合用药的耐药情况，以及耐药基因和毒力基因的分布，并分析感染患者的临床特征。
采用微量肉汤稀释法检测抗生素敏感性。通过聚合酶链反应（PCR）鉴定耐碳青霉烯类基因、孔蛋白和毒力基因。通过拉丝实验评估菌株黏附情况，并收集感染患者的临床资料。
在80株耐碳青霉烯类肺炎克雷伯菌（CRKP）菌株中，93.8%携带KPC-2，1.3%同时携带KPC-2和NDM。部分菌株缺乏OMPK35（6.2%）和OMPK36（10%）。毒力基因……普遍存在。与单一药物相比，碳青霉烯类、头孢菌素类和氨曲南与阿维巴坦联合用药显著降低了最低抑菌浓度（MIC）值（P<0.01）。阿维巴坦低浓度和高浓度之间的MIC存在显著差异（P<0.05）。
携带毒力基因的CRKP带来了重大风险。碳青霉烯类、头孢菌素类与阿维巴坦联合使用可增强对CRKP的抗菌活性。
