Peipei Song, Jian Xu, Lan Jiang, Qin Zhang, Chenggui Liu
{"title":"肉汤盘洗脱法评估阿兹曲南与头孢他啶/阿维菌素联合治疗肠杆菌分离物的效果。","authors":"Peipei Song, Jian Xu, Lan Jiang, Qin Zhang, Chenggui Liu","doi":"10.1128/spectrum.00953-24","DOIUrl":null,"url":null,"abstract":"<p><p>The combination of aztreonam with ceftazidime/avibactam is considered a potential therapeutic approach for the treatment of infections caused by metallo-β-lactamase (MBL)-producing isolates. In this study, <i>in vitro</i> antibacterial activity of aztreonam with avibactam against 204 carbapenemase-producing <i>Enterobacterales</i> was determined by broth disk elution (BDE) method of two detection volumes (5- and 2-mL broth), with broth microdilution (BMD) method as a reference. For the BDE-5mL test, the categorical agreement (CA) of ATM+CZA<sub>-lo</sub> tube (aztreonam/ceftazidime/avibactam: 6/6/4 mg/L) was 99.5%, with 0.5% major error (ME) and 0% very major error (VME); the CA of 2ATM+CZA<sub>-lo</sub> tube (12/6/4 mg/L) was 100%, with no ME and VME. For the BDE-2mL test, the CA of ATM+2CZA<sub>-hi</sub> tube (15/10/4 mg/L) was 98.5%, with 0% ME and 37.5% VME; the CA of 2ATM+2CZA<sub>-hi</sub> tube (30/10/4 mg/L) was 97.1%, with 0% ME and 75% VME. The BDE-5 mL test is an economical and practical method for clinical microbiology laboratories to determine the antibacterial susceptibility of aztreonam with avibactam against <i>Enterobacterales</i>, especially the 2ATM+CZA<sub>-lo</sub> tube with a final concentration of 12/6/4 mg/L of aztreonam/ceftazidime/avibactam.</p><p><strong>Importance: </strong>Infections caused by metallo-β-lactamase (MBL)-producing <i>Enterobacterales</i> are increasingly reported worldwide, and it is a significant challenge for clinical infection treatment. MBLs are adept at hydrolyzing almost all traditional β-lactam antibiotics except aztreonam, and the enzyme activity cannot be inhibited by traditional or novel β-lactamase inhibitors. The good thing is that the combination of aztreonam with ceftazidime/avibactam has been proven to be one of the potential therapeutic approaches for treating infections related with MBL-producing isolates. Broth microdilution (BMD) method is recommended as a reference method for its accuracy, but it is too complex to perform in most routine laboratories. Finding a more convenient, practical, and accurate susceptibility testing method for aztreonam/avibactam in clinical microbiology laboratories is very necessary. Here, we evaluated the performance of broth disk elution (BDE) method for aztreonam in combination with ceftazidime/avibactam against <i>Enterobacterales</i> isolates, with BMD as a reference.</p>","PeriodicalId":18670,"journal":{"name":"Microbiology spectrum","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448081/pdf/","citationCount":"0","resultStr":"{\"title\":\"Assessment of broth disk elution method for aztreonam in combination with ceftazidime/avibactam against <i>Enterobacterales</i> isolates.\",\"authors\":\"Peipei Song, Jian Xu, Lan Jiang, Qin Zhang, Chenggui Liu\",\"doi\":\"10.1128/spectrum.00953-24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The combination of aztreonam with ceftazidime/avibactam is considered a potential therapeutic approach for the treatment of infections caused by metallo-β-lactamase (MBL)-producing isolates. In this study, <i>in vitro</i> antibacterial activity of aztreonam with avibactam against 204 carbapenemase-producing <i>Enterobacterales</i> was determined by broth disk elution (BDE) method of two detection volumes (5- and 2-mL broth), with broth microdilution (BMD) method as a reference. For the BDE-5mL test, the categorical agreement (CA) of ATM+CZA<sub>-lo</sub> tube (aztreonam/ceftazidime/avibactam: 6/6/4 mg/L) was 99.5%, with 0.5% major error (ME) and 0% very major error (VME); the CA of 2ATM+CZA<sub>-lo</sub> tube (12/6/4 mg/L) was 100%, with no ME and VME. For the BDE-2mL test, the CA of ATM+2CZA<sub>-hi</sub> tube (15/10/4 mg/L) was 98.5%, with 0% ME and 37.5% VME; the CA of 2ATM+2CZA<sub>-hi</sub> tube (30/10/4 mg/L) was 97.1%, with 0% ME and 75% VME. The BDE-5 mL test is an economical and practical method for clinical microbiology laboratories to determine the antibacterial susceptibility of aztreonam with avibactam against <i>Enterobacterales</i>, especially the 2ATM+CZA<sub>-lo</sub> tube with a final concentration of 12/6/4 mg/L of aztreonam/ceftazidime/avibactam.</p><p><strong>Importance: </strong>Infections caused by metallo-β-lactamase (MBL)-producing <i>Enterobacterales</i> are increasingly reported worldwide, and it is a significant challenge for clinical infection treatment. MBLs are adept at hydrolyzing almost all traditional β-lactam antibiotics except aztreonam, and the enzyme activity cannot be inhibited by traditional or novel β-lactamase inhibitors. The good thing is that the combination of aztreonam with ceftazidime/avibactam has been proven to be one of the potential therapeutic approaches for treating infections related with MBL-producing isolates. Broth microdilution (BMD) method is recommended as a reference method for its accuracy, but it is too complex to perform in most routine laboratories. Finding a more convenient, practical, and accurate susceptibility testing method for aztreonam/avibactam in clinical microbiology laboratories is very necessary. 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Assessment of broth disk elution method for aztreonam in combination with ceftazidime/avibactam against Enterobacterales isolates.
The combination of aztreonam with ceftazidime/avibactam is considered a potential therapeutic approach for the treatment of infections caused by metallo-β-lactamase (MBL)-producing isolates. In this study, in vitro antibacterial activity of aztreonam with avibactam against 204 carbapenemase-producing Enterobacterales was determined by broth disk elution (BDE) method of two detection volumes (5- and 2-mL broth), with broth microdilution (BMD) method as a reference. For the BDE-5mL test, the categorical agreement (CA) of ATM+CZA-lo tube (aztreonam/ceftazidime/avibactam: 6/6/4 mg/L) was 99.5%, with 0.5% major error (ME) and 0% very major error (VME); the CA of 2ATM+CZA-lo tube (12/6/4 mg/L) was 100%, with no ME and VME. For the BDE-2mL test, the CA of ATM+2CZA-hi tube (15/10/4 mg/L) was 98.5%, with 0% ME and 37.5% VME; the CA of 2ATM+2CZA-hi tube (30/10/4 mg/L) was 97.1%, with 0% ME and 75% VME. The BDE-5 mL test is an economical and practical method for clinical microbiology laboratories to determine the antibacterial susceptibility of aztreonam with avibactam against Enterobacterales, especially the 2ATM+CZA-lo tube with a final concentration of 12/6/4 mg/L of aztreonam/ceftazidime/avibactam.
Importance: Infections caused by metallo-β-lactamase (MBL)-producing Enterobacterales are increasingly reported worldwide, and it is a significant challenge for clinical infection treatment. MBLs are adept at hydrolyzing almost all traditional β-lactam antibiotics except aztreonam, and the enzyme activity cannot be inhibited by traditional or novel β-lactamase inhibitors. The good thing is that the combination of aztreonam with ceftazidime/avibactam has been proven to be one of the potential therapeutic approaches for treating infections related with MBL-producing isolates. Broth microdilution (BMD) method is recommended as a reference method for its accuracy, but it is too complex to perform in most routine laboratories. Finding a more convenient, practical, and accurate susceptibility testing method for aztreonam/avibactam in clinical microbiology laboratories is very necessary. Here, we evaluated the performance of broth disk elution (BDE) method for aztreonam in combination with ceftazidime/avibactam against Enterobacterales isolates, with BMD as a reference.
期刊介绍：
Microbiology Spectrum publishes commissioned review articles on topics in microbiology representing ten content areas: Archaea; Food Microbiology; Bacterial Genetics, Cell Biology, and Physiology; Clinical Microbiology; Environmental Microbiology and Ecology; Eukaryotic Microbes; Genomics, Computational, and Synthetic Microbiology; Immunology; Pathogenesis; and Virology. Reviews are interrelated, with each review linking to other related content. A large board of Microbiology Spectrum editors aids in the development of topics for potential reviews and in the identification of an editor, or editors, who shepherd each collection.
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