阿维巴坦联合头孢他啶、氨曲南或美罗培南对耐碳青霉烯类肺炎克雷伯菌的体外抗菌活性
作者:
作者单位:

1.青岛市市立医院检验科, 山东 青岛 266000;2.复旦大学附属华山医院抗生素研究所, 上海 200040

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胡付品  E-mail: hufupin@163.com

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+2;R378.99+6]]>

基金项目:

青岛市卫生健康委员会B类重点学科


In vitro antimicrobial activity of avibactam in combination with ceftazidime, aztreonam or meropenem against carbapenem-resistant Klebsiella pneumoniae
Author:
Affiliation:

1.Department of Laboratory Medicine, Qingdao Municipal Hospital, Qingdao 266000, China;2.Institute of Antibiotics, Hua-shan Hospital, Fudan University, Shanghai 200040, China

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    摘要:

    目的 研究阿维巴坦(固定浓度为4 μg/mL)联合β-内酰胺类抗生素对耐碳青霉烯类肺炎克雷伯菌(CRKP)的体外抗菌活性。 方法 收集某院临床分离的非重复CRKP, 采用微量肉汤稀释法测定头孢他啶/阿维巴坦、氨曲南/阿维巴坦、美罗培南/阿维巴坦对CRKP的最低抑菌浓度(MIC)和最低杀菌浓度(MBC), 采用聚合酶链反应(PCR)方法测定碳青霉烯酶等耐药基因。 结果 63株CRKP菌株, 57株携带blaKPC基因, 5株携带金属酶基因, 1株未检出常见碳青霉烯酶耐药基因。57株blaKPC基因阳性的CRKP菌株, 头孢他啶/阿维巴坦、氨曲南/阿维巴坦、美罗培南/阿维巴坦对其MIC均分别≤ 8/4、4/4、0.5/4 μg/mL, 阿维巴坦使头孢他啶、氨曲南及美罗培南对其MIC50及MIC90值明显下降。5株金属酶基因阳性的CRKP菌株, 阿维巴坦未使头孢他啶、美罗培南MIC90值有所下降, 但阿维巴坦可使氨曲南MIC90下降达99.8%。三种阿维巴坦的复方制剂对63株CRKP的MBC50值与MIC50值相同, 其MBC90值与MIC90值相同。 结论 阿维巴坦与三种常见β-内酰胺类抗生素(头孢他啶、氨曲南、美罗培南)联合对表达KPC-2型碳青霉烯酶的CRKP菌株具有较好的抗菌效果, 与头孢他啶或美罗培南联合对携带金属酶的CRKP菌株无抑制作用, 但联合氨曲南对携带金属酶的CRKP菌株具有较好的抗菌效果。

    Abstract:

    Objective To study in vitro antimicrobial activity of combination of avibatam (fixed concentration of 4 μg/mL) and β-lactam antibiotics against carbapenem-resistant Klebsiella pneumoniae(CRKP). Methods Non-repetitive CRKP strains isolated from a hospital were collected, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of ceftazidime/avibatam, aztreonam/avibatam, and meropenem/avibatam against CRKP was detected with broth microdilution method, carbapenemase resistance genes were determined by polymerase chain reaction (PCR). Results Among 63 CRKP strains, 57 strains harbored blaKPC gene, 5 strains harbored metalloenzyme gene, and 1 strain did not found common carbapenem-resistant gene. Among 57 CRKP strains with positive blaKPC gene, MICs of ceftazidime/avibatam, aztreonam/avibatam, and meropenem/avibatam were ≤8/4, 4/4, and 0.5/4 μg/mL respectively, avibatam significantly decreased the MIC50 and MIC90 values of ceftazidime, aztreonam and meropenem. Among 5 CRKP strains with positive metalloenzyme gene, avibatam did not decrese MIC90 of ceftazidime and meropenem, but decreased MIC90 of aztreonam by 99.8%, MBC50 and MIC50 of three compound of avibatam against 63 strains of CRKP were identical, their MBC90 and MIC90 were identical. Conclusion Combination of avibatam with three common β-lactam antibiotics (ceftazidime, aztreonam and meropenem) has a good antimicrobial effect on CRKP strains expressing KPC-2 carbapenemase, combination with ceftazidime or meropenem has no inhibitory effect on metalloenzyme-harboring CRKP strains, but combination with aztreonam has a good antimicrobial effect on metalloenzyme-harboring CRKP strains.

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引用本文

于梦,王玉洁,于清华,等.阿维巴坦联合头孢他啶、氨曲南或美罗培南对耐碳青霉烯类肺炎克雷伯菌的体外抗菌活性[J]. 中国感染控制杂志,2022,(3):239-244. DOI:10.12138/j. issn.1671-9638.20222098.
Meng YU, Yu-jie WANG, Qing-hua YU, et al. In vitro antimicrobial activity of avibactam in combination with ceftazidime, aztreonam or meropenem against carbapenem-resistant Klebsiella pneumoniae[J]. Chin J Infect Control, 2022,(3):239-244. DOI:10.12138/j. issn.1671-9638.20222098.

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  • 收稿日期:2021-11-04
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  • 在线发布日期: 2024-04-28
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