Geographic differences in susceptibility profiles of potential non-class B carbapenemase-producing Enterobacterales isolates against ceftazidime-avibactam, meropenem-vaborbactam, colistin, amikacin, gentamicin, and tigecycline: Data from the Antimicrobial Testing Leadership and Surveillance, 2018–2022

IF 4.9 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Antimicrobial Agents Pub Date : 2024-10-24 DOI:10.1016/j.ijantimicag.2024.107363

Shio-Shin Jean , Wen-Chien Ko , I-Min Liu , Po-Chuen Hsieh , Po-Ren Hsueh

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Abstract

To evaluate the susceptibility profiles of regional meropenem-resistant potential non-class B carbapenemase-producing Enterobacterales (CPE) isolates (without confirmation by phenotypic tests) against important antibiotics, we extracted data from the 2018-2022 Antimicrobial Testing Leadership and Surveillance. This data included susceptibility information of meropenem-resistant potential non-class B CPE isolates against indicated antibiotics – amikacin, gentamicin, ceftazidime-avibactam, colistin, meropenem-vaborbactam, and tigecycline – from sepsis patients hospitalized in intensive care units across six major regions. Carbapenemase-encoding genes of the tested CPE isolates, determined by multiplex PCR and Sanger sequencing, were also analyzed. Susceptibility breakpoints recommended by Clinical and Laboratory Standards Institute 2024 and US FDA criteria (for tigecycline only) against Enterobacterales were employed. A total of 1500 potential non-class B CPE isolates (89% of which were Klebsiella pneumoniae) were tested globally. Resistance rates to amikacin and gentamicin against the evaluated isolates were statistically higher in Africa/the Middle East, Europe, and India compared to other regions. A similar pattern was observed in the susceptibility of these potential CPE isolates to ceftazidime-avibactam and meropenem-vaborbactam. High colistin resistance rates were noted in Asia, Latin America, and Europe (29%–35%). Furthermore, the proportions of potential CPE isolates carrying genes encoding bla_OXA variants were notably higher among the tested CPE isolates in India, Europe, and Africa/the Middle East regions (99.2%, 53.3%, and 96.7%, respectively) compared to other regions. Trends in resistance to important antibiotics among potential non-class B CPE isolates warrant close monitoring.

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潜在非 B 类产碳青霉烯酶肠杆菌分离株对头孢唑肟-阿维巴坦、美罗培南-瓦巴坦、可乐定、阿米卡星、庆大霉素和替加环素的药敏谱地域差异：2018-2022年抗菌药物检测领导与监测数据。

为了评估区域性美罗培南耐药（MEM-R）潜在非 B 类产碳青霉烯酶肠杆菌（CPE）分离物（未经表型试验确认）对重要抗生素的药敏谱，我们从 2018-2022 年抗菌药物检测领导与监测中提取了数据。这些数据包括 MEM-R 潜在非 B 类 CPE 分离物对指定抗生素（阿米卡星 [AMK]、庆大霉素 [GM]、头孢唑肟-阿维巴坦 [CZA]、可乐定 [CST]、美罗培南-瓦巴坦 [MVB] 和替加环素 [TGC]）的药敏信息，这些抗生素来自六个主要地区的 ICU 住院败血症患者。此外，还分析了通过多重 PCR 和 Sanger 测序确定的受检 CPE 分离物的碳青霉烯酶编码基因。采用了 CLSI 2024 和美国 FDA 标准（仅针对 TGC）推荐的肠杆菌属药物敏感性断点。全球共检测了 1,500 份潜在的非 B 类 CPE 分离物（其中 89% 为肺炎克雷伯菌）。据统计，非洲/中东、欧洲和印度的分离菌株对 AMK 和 GM 的耐药率高于其他地区。这些潜在的 CPE 分离物对 CZA 和 MVB 的敏感性也呈现出类似的模式。亚洲、拉丁美洲和欧洲的 CST 耐药率较高（29%-35%）。此外，与其他地区相比，印度、欧洲和非洲/中东地区的潜在 CPE 分离物中携带编码 blaOXA 变异基因的比例明显更高（分别为 99.2%、53.3% 和 96.7%）。潜在的非 B 类 CPE 分离物对重要抗生素的耐药性趋势值得密切关注。

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来源期刊

International Journal of Antimicrobial Agents 医学-传染病学

CiteScore

21.60

自引率

0.90%

发文量

176

审稿时长

36 days

期刊介绍： The International Journal of Antimicrobial Agents is a peer-reviewed publication offering comprehensive and current reference information on the physical, pharmacological, in vitro, and clinical properties of individual antimicrobial agents, covering antiviral, antiparasitic, antibacterial, and antifungal agents. The journal not only communicates new trends and developments through authoritative review articles but also addresses the critical issue of antimicrobial resistance, both in hospital and community settings. Published content includes solicited reviews by leading experts and high-quality original research papers in the specified fields.