Evaluation of In Vitro Activity of Ceftolozane/Tazobactam and Ceftazidime/Avibactam Against Carbapenem-Resistant Pseudomonas aeruginosa Strains and Mechanisms of Carbapenem Resistance: Data from Tertiary Care Hospital

IF 0.5 4区医学 Q4 MICROBIOLOGY

Jundishapur Journal of Microbiology Pub Date : 2023-06-04 DOI:10.5812/jjm-134090

G. Hazırolan, Ceren Özkul

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引用次数: 0

Abstract

Background: Carbapenem-resistant Pseudomonas aeruginosa is an endemic problem in several countries, notably Turkey. Objectives: This study aimed to investigate the underlying mechanisms contributing to the carbapenem resistance phenotype and enhance the in-vitro activity of ceftolozane-tazobactam (C/T) and ceftazidime-avibactam (C/A) against carbapenem-resistant P. aeruginosa strains. Methods: A total of 114 carbapenem-resistant P. aeruginosa strains were isolated from different types of clinical specimens. The tested antibiotics were evaluated using the antibiotic disk diffusion method. Additionally, C/T and C/A were tested using the gradient test method. The efficacy of phenylalanine-arginine-β-naphthylamide (PAβN) as efflux pump inhibitors was assessed to determine their ability to reduce meropenem minimum inhibitory concentrations. Polymerase chain reaction (PCR) assays were conducted to identify blaIMP, blaVIM, and blaNDM-1. Results: Among 114 strains of carbapenem-resistant P. aeruginosa, overall resistance rates for C/T and C/A were 10.7% and 8.8%, respectively. Efflux pump inhibitor-based antibiotic susceptibility testing indicated that 35.08% of strains showed resistance modulated by PAβN. Among the strains, 27 (24.5%) were found to produce metallo-beta-lactamase (MBL), with blaVIM (17 strains, 14.91%) being the most common, followed by blaIMP (12 strains, 10.53%). Conclusions: Emerging carbapenem resistance in P. aeruginosa strains is a serious therapeutic challenge for clinicians. Carbapenem resistance can be influenced by various factors, some of which were not assessed in our study. Nonetheless, our results revealed that the main mechanism associated with carbapenem-resistant P. aeruginosa strains is a PAβN-sensitive efflux pump. Among acquired MBLs, VIM-type enzymes were found to be the most prevalent.

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头孢托洛赞/他唑巴坦和头孢他啶/阿维巴坦对碳青霉烯耐药铜绿假单胞菌的体外活性评价及碳青霉烯耐药性机制：来自三级医院的数据

背景：碳青霉烯耐药性铜绿假单胞菌是几个国家的地方病，尤其是土耳其。目的：本研究旨在探讨导致碳青霉烯耐药性表型的潜在机制，并增强头孢托洛嗪-他唑巴坦（C/T）和头孢他啶-阿维巴坦（C/C）对碳青霉烯耐药铜绿假单胞菌的体外活性。方法：从不同类型的临床标本中分离出114株碳青霉烯耐药铜绿假单胞菌。使用抗生素圆盘扩散法对测试的抗生素进行评估。此外，使用梯度测试方法对C/T和C/A进行了测试。评估了苯丙氨酸精氨酸-β-萘酰胺（PAβN）作为外排泵抑制剂的疗效，以确定其降低美罗培南最低抑制浓度的能力。进行聚合酶链式反应（PCR）测定以鉴定blaIMP、blaVIM和blaNDM-1。结果：114株耐碳青霉烯的铜绿假单胞菌对C/T和C/A的总耐药率分别为10.7%和8.8%。基于外排泵抑制剂的抗生素敏感性测试表明，35.08%的菌株表现出PAβN调节的耐药性。在这些菌株中，27株（24.5%）产生金属β-内酰胺酶，其中blaVIM（17株，14.91%）最常见，其次是blaIMP（12株，10.53%）。碳青霉烯耐药性可能受到各种因素的影响，其中一些因素在我们的研究中没有进行评估。尽管如此，我们的研究结果表明，与碳青霉烯耐药性铜绿假单胞菌菌株相关的主要机制是PAβN-敏感外排泵。在获得性MBL中，VIM型酶被发现是最普遍的。

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来源期刊

Jundishapur Journal of Microbiology MICROBIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Jundishapur Journal of Microbiology, (JJM) is the official scientific Monthly publication of Ahvaz Jundishapur University of Medical Sciences. JJM is dedicated to the publication of manuscripts on topics concerning all aspects of microbiology. The topics include medical, veterinary and environmental microbiology, molecular investigations and infectious diseases. Aspects of immunology and epidemiology of infectious diseases are also considered.