Activity of β-Lactamase Inhibitor Combinations Against Enterobacterales Isolated from Patients with Intra-Abdominal Infection from United States Medical Centres (2019-2023).

IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES
Helio S Sader, John H Kimbrough, Marisa L Winkler, Rodrigo E Mendes, Mariana Castanheira
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引用次数: 0

Abstract

Objective: To evaluate the antimicrobial susceptibility of Enterobacterales isolated from patients with intra-abdominal infections (IAI) in United States (US) medical centres. Methods: A total of 2036 isolates (1/patient) were consecutively collected from patients with IAI in 63 US hospitals in 2019-2023 and susceptibility tested by broth microdilution. Carbapenem-resistant Enterobacterales (CRE) were screened for carbapenemases by whole genome sequencing. Results: The most common Enterobacterales species were E. coli (47.1%), K. pneumoniae (18.7%), and E. cloacae species complex (9.8%). The most active agents were aztreonam-avibactam (MIC50/90, ≤0.03/0.12 mg/L), ceftazidime-avibactam (MIC50/90, 0.12/0.25 mg/L), and meropenem-vaborbactam (MIC50/90, 0.03/0.06 mg/L) with 99.9% susceptibility. A multidrug-resistant (MDR) phenotype (nonsusceptibility to ≥3 classes) was observed in 21.4% of Enterobacterales (n = 436). Piperacillin-tazobactam was active against 87.2% of Enterobacterales overall and 50.2% of MDR isolates, and meropenem was active against 99.2% of Enterobacterales and 96.1% of MDR isolates. Only 51.6% of Enterobacterales were susceptible to ampicillin-sulbactam. An acquired broad-spectrum β-lactamase gene was identified in 207 (10.2%) isolates and included extended-spectrum β-lactamases (ESBL; n = 182), transferable AmpC (n = 24) and carbapenemases (n = 9). Eight isolates produced two β-lactamase classes. Conclusions: Aztreonam-avibactam, ceftazidime-avibactam, and meropenem-vaborbactam exhibited almost complete activity (99.9% susceptibility) against Enterobacterales causing IAI in US hospitals. In contrast, piperacillin-tazobactam exhibited limited activity against these organisms, especially those with a MDR phenotype.

β-内酰胺酶抑制剂组合对美国医疗中心腹腔感染患者分离肠杆菌的活性(2019-2023)
目的:评价美国医疗中心腹腔感染(IAI)患者分离的肠杆菌的抗菌药物敏感性。方法:从2019-2023年美国63家医院IAI患者中连续采集2036株(1例/例),采用微量肉汤稀释法进行药敏试验。采用全基因组测序方法筛选耐碳青霉烯类肠杆菌(CRE)。结果:最常见的肠杆菌种类为大肠杆菌(47.1%)、肺炎克雷伯菌(18.7%)和阴沟肠杆菌复合体(9.8%)。活性最强的药物为阿曲仑-阿维巴坦(MIC50/90,≤0.03/0.12 mg/L)、头孢他啶-阿维巴坦(MIC50/90, 0.12/0.25 mg/L)和美罗培尼-瓦波巴坦(MIC50/90, 0.03/0.06 mg/L),敏感性为99.9%。21.4%的肠杆菌(n = 436)存在多药耐药表型(对≥3个类别不敏感)。哌哌西林-他唑巴坦对87.2%的肠杆菌和50.2%的耐多药菌株有活性,美罗培南对99.2%的肠杆菌和96.1%的耐多药菌株有活性。仅有51.6%的肠杆菌对氨苄青霉素-舒巴坦敏感。在207株(10.2%)分离物中鉴定出获得性广谱β-内酰胺酶基因,包括广谱β-内酰胺酶(ESBL;n = 182),可转移AmpC (n = 24)和碳青霉烯酶(n = 9)。8株菌株产生2种β-内酰胺酶。结论:氨曲南-阿维巴坦、头孢他啶-阿维巴坦和美罗培尼-瓦波巴坦对美国医院引起IAI的肠杆菌具有几乎完全的活性(99.9%的敏感性)。相比之下,哌拉西林-他唑巴坦对这些生物体的活性有限,特别是那些具有耐多药表型的生物体。
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来源期刊
Antibiotics-Basel
Antibiotics-Basel Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics
CiteScore
7.30
自引率
14.60%
发文量
1547
审稿时长
11 weeks
期刊介绍: Antibiotics (ISSN 2079-6382) is an open access, peer reviewed journal on all aspects of antibiotics. Antibiotics is a multi-disciplinary journal encompassing the general fields of biochemistry, chemistry, genetics, microbiology and pharmacology. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on the length of papers.
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