In vitro antimicrobial activity of avibactam in combination with ceftazidime, aztreonam or meropenem against carbapenem-resistant Klebsiella pneumoniae
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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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+2;R378.99+6]]>

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    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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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].中国感染控制杂志英文版,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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  • Received:November 04,2021
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  • Online: April 28,2024
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