In vitro activity of ceftolozane/tazobactam against Gram-negative bacilli isolated from pediatric patients: Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART) 2017–2021, China

IF 3.7 3区 医学 Q2 INFECTIOUS DISEASES
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Abstract

Objectives

Ceftolozane-tazobactam (C/T) is a combination of a cephalosporin and a β-lactamase inhibitor with activity against Gram-negative bacilli (GNB). The study aims were to evaluate the activity of C/T in vitro vs. comparators against clinical GNB isolated from Chinese paediatric patients.

Methods

From 2017–2021, 660 GNB isolates were collected from 20 hospitals across China. The minimum inhibitory concentrations were tested using a Trek Diagnostic System (Thermo Fisher Scientific). Susceptibility was determined by CLSI broth microdilution and the results were interpreted according to CLSI M100 (2021) breakpoints.

Results

GNB isolates were obtained from paediatric patients < 18 years old, mainly from the bloodstream (n = 146), intraperitoneal cavity (n = 138), lower respiratory (n = 278) and urinary tract (n = 96). Overall, C/T was active against 76.6% of 436 Enterobacterales, with a descending susceptibility rate of 100.0% to S. marcescens, 92.2% to E. coli, 83.3% to K. oxytoca, 66.7% to K. aerogenes, 66.7% to P. mirabilis, 58.6% to K. pneumoniae and 57.1% to E. cloacae. The susceptibility of P. aeruginosa to C/T was 89.4%, which was the highest among the β-lactam antibiotics and was second only to amikacin (92.9%). Isolates of respiratory tract infection (RTI) derived P. aeruginosa were highly susceptible (93.8%) to C/T, while <75% of isolates of RTI derived P. aeruginosa were susceptible to the other β-lactam antibiotics tested, except for ceftazidime-avibactam (91.2%).

Conclusion

GNBs collected from paediatric patients in China showed a high susceptibility to C/T making this drug combination an effective choice for treating the paediatric population, especially those infected with P. aeruginosa.

头孢妥仑/他唑巴坦对儿科患者分离的革兰氏阴性杆菌的体外活性:中国2017-2021年抗菌药物耐药性趋势监测研究(SMART)的结果。
目的:头孢洛赞-他唑巴坦(C/T)是头孢菌素与β-内酰胺酶抑制剂的复方制剂,对革兰阴性杆菌(GNB)具有活性。研究目的是评估C/T在体外对中国儿科患者分离的临床革兰氏阴性杆菌的活性:2017-2021年,从全国20家医院收集了660株GNB分离株。使用 Trek 诊断系统(赛默飞世尔科技公司)检测最低抑菌浓度。采用 CLSI 肉汤微量稀释法测定药敏性,并根据 CLSI M100(2021 年)断点解释结果:GNB分离菌株来自18岁以下的儿科患者,主要来自血流(146株)、腹腔(138株)、下呼吸道(278株)和泌尿道(96株)。总体而言,C/T 对 436 种肠杆菌中的 76.6% 具有活性,对 S. marcescens 的敏感率依次为 100.0%、对 E. coli 的敏感率依次为 92.2%、对 K. oxytoca 的敏感率依次为 83.3%、对 K. aerogenes 的敏感率依次为 66.7%、对 P. mirabilis 的敏感率依次为 66.7%、对 K. pneumoniae 的敏感率依次为 58.6%、对 E. cloacae 的敏感率依次为 57.1%。铜绿假单胞菌对 C/T 的敏感性为 89.4%,在 β-内酰胺类药物中最高,仅次于阿米卡星(92.9%)。来自呼吸道感染(RTI)的铜绿假单胞菌分离株对C/T高度敏感(93.8%),而来自RTI的铜绿假单胞菌分离株中,除头孢唑肟-阿维巴坦(91.2%)外,小于75%的分离株对测试的其他β-内酰胺类药物敏感:结论:从中国儿科患者中收集的 GNB 对 C/T 具有高度敏感性,因此这种药物组合是治疗儿科患者,尤其是铜绿假单胞菌感染者的有效选择。
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来源期刊
Journal of global antimicrobial resistance
Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY
CiteScore
8.70
自引率
2.20%
发文量
285
审稿时长
34 weeks
期刊介绍: The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.
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