{"title":"多中心评估阿兹曲南与阿维巴坦、雷贝他坦和伐博巴坦联用对产生金属-β-内酰胺酶的耐碳青霉烯革兰阴性杆菌的活性。","authors":"Lili Tao, Ashley Dahlquist, Harley Harris, Emily Jacobs, Eric Wenzler, Patricia J Simner, Romney Humphries","doi":"10.1128/aac.00693-24","DOIUrl":null,"url":null,"abstract":"<p><p>Treatment options for carbapenem-resistant gram-negative bacilli (CR-GNB), especially metallo-β-lactamase (MBL)-producing CR-GNB, are limited. Aztreonam (ATM) in combination with avibactam (AVI) has shown potential for treating MBL-producing carbapenem-resistant Enterobacterales (CREs) and <i>Stenotrophomonas maltophilia</i>. However, data on ATM in combination with other β-lactamase inhibitors (BLIs) are limited. We performed a multicenter study to evaluate the <i>in vitro</i> activities of ATM in combination with AVI, vaborbactam (VAB), relebactam (REL), tazobactam (TAZ) as well as with their commercially available formulations against CREs and <i>S. maltophilia</i> using broth microdilution. AVI restored ATM activity for MBL-producing CREs (ATM: 9.8% vs ATM-AVI: 78.0%) and <i>S. maltophilia</i> (ATM: 0% vs ATM-AVI: 93.3%). REL also moderately restored activity of ATM in MBL-producing CREs (ATM: 9.8% vs ATM-REL: 42.7%) and <i>S. maltophilia</i> (ATM: 0% vs ATM-REL: 68.9%). VAB and TAZ demonstrated very limited effect on the activity of ATM against CR-GNB evaluated. The combination of ATM with ceftazidime-AVI (CAZ-AVI) demonstrated maximum activity against CREs. Although ATM-CAZ-AVI is the most potent regimen available for CREs and <i>S. maltophilia</i>, ATM-IMI-REL might be a reasonable alternative.</p>","PeriodicalId":8152,"journal":{"name":"Antimicrobial Agents and Chemotherapy","volume":null,"pages":null},"PeriodicalIF":4.1000,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multicenter evaluation of activity of aztreonam in combination with avibactam, relebactam, and vaborbactam against metallo-β-lactamase-producing carbapenem-resistant gram-negative bacilli.\",\"authors\":\"Lili Tao, Ashley Dahlquist, Harley Harris, Emily Jacobs, Eric Wenzler, Patricia J Simner, Romney Humphries\",\"doi\":\"10.1128/aac.00693-24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Treatment options for carbapenem-resistant gram-negative bacilli (CR-GNB), especially metallo-β-lactamase (MBL)-producing CR-GNB, are limited. Aztreonam (ATM) in combination with avibactam (AVI) has shown potential for treating MBL-producing carbapenem-resistant Enterobacterales (CREs) and <i>Stenotrophomonas maltophilia</i>. However, data on ATM in combination with other β-lactamase inhibitors (BLIs) are limited. We performed a multicenter study to evaluate the <i>in vitro</i> activities of ATM in combination with AVI, vaborbactam (VAB), relebactam (REL), tazobactam (TAZ) as well as with their commercially available formulations against CREs and <i>S. maltophilia</i> using broth microdilution. AVI restored ATM activity for MBL-producing CREs (ATM: 9.8% vs ATM-AVI: 78.0%) and <i>S. maltophilia</i> (ATM: 0% vs ATM-AVI: 93.3%). REL also moderately restored activity of ATM in MBL-producing CREs (ATM: 9.8% vs ATM-REL: 42.7%) and <i>S. maltophilia</i> (ATM: 0% vs ATM-REL: 68.9%). VAB and TAZ demonstrated very limited effect on the activity of ATM against CR-GNB evaluated. The combination of ATM with ceftazidime-AVI (CAZ-AVI) demonstrated maximum activity against CREs. Although ATM-CAZ-AVI is the most potent regimen available for CREs and <i>S. maltophilia</i>, ATM-IMI-REL might be a reasonable alternative.</p>\",\"PeriodicalId\":8152,\"journal\":{\"name\":\"Antimicrobial Agents and Chemotherapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2024-08-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Antimicrobial Agents and Chemotherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1128/aac.00693-24\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Antimicrobial Agents and Chemotherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1128/aac.00693-24","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
耐碳青霉烯革兰阴性杆菌（CR-GNB），尤其是产金属-β-内酰胺酶（MBL）的 CR-GNB 的治疗方案有限。氨曲南（Attreonam，ATM）与阿维巴坦（avibactam，AVI）联用已显示出治疗产甲氧苄氨嘧啶耐药肠杆菌（CREs）和嗜麦芽糖血单胞菌的潜力。然而，ATM 与其他 β-内酰胺酶抑制剂（BLIs）联用的数据还很有限。我们进行了一项多中心研究，采用肉汤微稀释法评估了 ATM 与 AVI、伐伯巴坦（VAB）、雷贝内酰胺（REL）、他唑巴坦（TAZ）及其市售制剂联用对 CRE 和嗜麦芽单胞菌的体外活性。AVI 恢复了 ATM 对产生 MBL 的 CRE（ATM：9.8% vs ATM-AVI：78.0%）和嗜麦芽糖酵母菌（ATM：0% vs ATM-AVI：93.3%）的活性。REL 也能适度恢复 ATM 在产生 MBL 的 CRE（ATM：9.8% vs ATM-REL：42.7%）和嗜麦芽糖酵母菌（ATM：0% vs ATM-REL：68.9%）中的活性。VAB和TAZ对ATM抗CR-GNB活性的影响非常有限。ATM 与头孢他啶-AVI（CAZ-AVI）的组合对 CRE 的活性最高。尽管 ATM-CAZ-AVI 是目前对 CREs 和嗜麦芽糖酵母菌最有效的方案，但 ATM-IMI-REL 也不失为一种合理的替代方案。
Multicenter evaluation of activity of aztreonam in combination with avibactam, relebactam, and vaborbactam against metallo-β-lactamase-producing carbapenem-resistant gram-negative bacilli.
Treatment options for carbapenem-resistant gram-negative bacilli (CR-GNB), especially metallo-β-lactamase (MBL)-producing CR-GNB, are limited. Aztreonam (ATM) in combination with avibactam (AVI) has shown potential for treating MBL-producing carbapenem-resistant Enterobacterales (CREs) and Stenotrophomonas maltophilia. However, data on ATM in combination with other β-lactamase inhibitors (BLIs) are limited. We performed a multicenter study to evaluate the in vitro activities of ATM in combination with AVI, vaborbactam (VAB), relebactam (REL), tazobactam (TAZ) as well as with their commercially available formulations against CREs and S. maltophilia using broth microdilution. AVI restored ATM activity for MBL-producing CREs (ATM: 9.8% vs ATM-AVI: 78.0%) and S. maltophilia (ATM: 0% vs ATM-AVI: 93.3%). REL also moderately restored activity of ATM in MBL-producing CREs (ATM: 9.8% vs ATM-REL: 42.7%) and S. maltophilia (ATM: 0% vs ATM-REL: 68.9%). VAB and TAZ demonstrated very limited effect on the activity of ATM against CR-GNB evaluated. The combination of ATM with ceftazidime-AVI (CAZ-AVI) demonstrated maximum activity against CREs. Although ATM-CAZ-AVI is the most potent regimen available for CREs and S. maltophilia, ATM-IMI-REL might be a reasonable alternative.
期刊介绍：
Antimicrobial Agents and Chemotherapy (AAC) features interdisciplinary studies that build our understanding of the underlying mechanisms and therapeutic applications of antimicrobial and antiparasitic agents and chemotherapy.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
