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首页> 外文期刊>Journal of Thoracic Disease >In vitro potency of antipseudomonal β-lactams against blood and respiratory isolates of P. aeruginosa collected from US hospitals
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In vitro potency of antipseudomonal β-lactams against blood and respiratory isolates of P. aeruginosa collected from US hospitals

机译：从美国医院收集的抗假性β-内酰胺类药物对铜绿假单胞菌血液和呼吸道分离物的体外效能

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Background: Challenges due to multidrug resistant (MDR) Gram-negative bacterial pathogens such as P. aeruginosa (PSA) are increasing globally. Suboptimal antimicrobial therapy of infections caused by PSA is associated with increased morbidity and mortality. As a result, antimicrobial susceptibility (%S) studies are pivotal to identifying trends in antimicrobial resistance that inform decisions regarding choice of antimicrobial therapy. This study assessed the in vitro potency of 7 antipseudomonal agents including ceftolozane/tazobactam (C/T) against PSA collected from numerous sites across the US. Methods: Multiple US hospitals provided non-duplicate respiratory and blood isolates of PSA for potency testing. MICs against PSA were determined using broth microdilution methods according to CLSI for 7 antimicrobials with antipseudomonal activity: aztreonam (ATM), cefepime (FEP), ceftazidime (CAZ), C/T, imipenem (IPM), meropenem (MEM) and piperacillin/tazobactam (TZP). %S was defined per CLSI or FDA breakpoint criteria. Results: Thirty-five hospitals geographically spread across the US provided a total of 1,209 PSA isolates. Of the antibiotics assessed, %S to C/T was the highest at 95% with an MIC 50 of 0.5 mg/L and MIC 90 of 2 mg/L. In comparison, other %S (MIC 50 /MIC 90 ) was as follows: ATM 66% (8/32); FEP 76% (4/32); CAZ 78% (4/64); IPM 68% (2/16); MEM 74% (0.5/16); and TZP 73% (8/128). Conclusions: For this geographically diverse PSA population, C/T demonstrated the highest overall susceptibility (95%). Other antipseudomonal agents inclusive of the carbapenems displayed susceptibilities of 66–78%. In the era of escalating PSA resistance to the β-lactams, the potency of C/T may represent an important clinical option.
机译：背景：多重耐药性（MDR）引起的挑战诸如铜绿假单胞菌（PSA）等革兰氏阴性细菌病原体在全球范围内日益增加。对PSA引起的感染的抗微生物治疗欠佳会增加发病率和死亡率。因此，抗微生物药敏性（％S）研究对于确定抗微生物药耐药性趋势至关重要，这些趋势可为有关抗微生物治疗选择的决策提供依据。这项研究评估了从美国各地收集的7种抗假性伪狂剂（包括头孢噻嗪/他唑巴坦（C / T））对PSA的体外效力。方法：美国多家医院提供了PSA非重复呼吸道和血液分离株，以进行效能测试。根据CLSI，使用肉汤微稀释法对7种具有抗假性抗菌活性的抗微生物剂测定了针对PSA的MIC：氨曲南（ATM），头孢吡肟（FEP），头孢他啶（CAZ），C / T，亚胺培南（IPM），美罗培南（MEM）和哌拉西林/他唑巴坦（TZP）。 ％S是根据CLSI或FDA断点标准定义的。结果：遍布美国的35所医院共提供了1,209个PSA分离株。在评估的抗生素中，C / T的％S最高，为95％，MIC 50为0.5 mg / L，MIC 90为2 mg / L。相比之下，其他％S（MIC 50 / MIC 90）如下：ATM 66％（8/32）; FEP 76％（4/32）; CAZ 78％（4/64）; IPM 68％（2/16）; MEM 74％（0.5 / 16）;和TZP 73％（8/128）。结论：对于这个地理上不同的PSA人群，C / T表现出最高的总体敏感性（95％）。包括碳青霉烯类在内的其他抗假性伪药显示出66-78％的敏感性。在PSA对β-内酰胺的耐药性不断升级的时代，C / T的效力可能代表了重要的临床选择。

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