新型抗假单胞菌β -内酰胺- β -内酰胺酶抑制剂对铜绿假单胞菌呼吸分离株的抗菌活性在法国监测耐药性趋势（SMART）项目（2016-2022）中恢复。

IF 2.2 4区医学 Q2 INFECTIOUS DISEASES

Infectious diseases now Pub Date : 2025-03-13 DOI:10.1016/j.idnow.2025.105056

Charlie Zins , Hélène Pailhoriès , Rachel Chenouard , Stéphane Corvec , Sandrine Dahyot , Paul-Louis Woerther , Catherine Eckert , Gautier Pierrat , Xavier Bourge , Sophie Boyer , Marie Kempf

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引用次数: 0

摘要

目的：评估2016-2022年法国SMART研究中头孢唑烷/他唑巴坦（C/T）和比较物对呼吸道感染（RTI）中分离的铜绿假单胞菌的敏感性。方法：根据EUCAST-2022指南，对法国5家医院收集的717株铜绿假单胞菌进行药敏试验和最低抑菌浓度（mic）测定和解释。对铜绿假单胞菌（P. aeruginosa）亚胺培南和/或C/T耐药菌株进行了广谱β-内酰胺酶（ESBLs）、AmpC和碳青霉烯酶基因的PCR筛选。对鉴定的基因进行测序并确定变异。结果:总的来说,96.5 %的铜绿假单胞菌分离是容易C / T,脆弱的感情相当的meropenem-vaborbactam(多功能车辆总线 = 96.5 %),imipenem / relebactam (IMI / REL = 96.9  %)和ceftazidime-avibactam (97.0 C / A =  %)。717株菌株的C/T MIC50和MIC90分别为0.5和2 mg/L。242株菌株对至少一种β-内酰胺类假单胞菌耐药（33.7% %），对C/T、C/A、MVB和IMI/REL敏感（接近90% %）。在对哌拉西林-他唑巴坦、头孢吡肟和头孢他啶耐药的80株菌株中，76.3 %对C/T敏感，只有IMI/REL和阿米卡星的敏感性超过80% %。32株亚胺培南、美罗培南耐药菌株中，仅对IMI/REL、C/T、C/A的敏感性超过60% %。这些菌株对C/T的MIC50为2 mg/L，对C/A的MIC50为8 mg/L。IMI/REL对25株C/T耐药菌株的活性最强（72 %）。最后，53株亚胺培南和/或C/T-R分离株含有C类β-内酰胺（blaPDC）变体，其中一株还携带blaPER-1基因，另一株携带blaVIM-2基因。结论：C/T治疗铜绿假单胞菌所致RTI是一种可靠的治疗方法。

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Antimicrobial activity of new anti-Pseudomonas beta-lactam-beta-lactamase inhibitors against Pseudomonas aeruginosa respiratory isolates recovered during the study for Monitoring Antimicrobial Resistance Trends (SMART) program in France (2016–2022)

Objectives

To assess the susceptibility of ceftolozane/tazobactam (C/T) and comparators to Pseudomonas aeruginosa isolates recovered from respiratory-tract-infections (RTI) between 2016–2022 in the French SMART study.

Methods

Antibiotic susceptibility testing and minimum inhibitory concentrations (MICs) of 717 P.aeruginosa isolates collected in five French hospitals were determined and interpreted according to the EUCAST-2022 guidelines. P. aeruginosa isolates resistant (R) to imipenem and/or C/T were screened by PCR for extended-spectrum-β-lactamases (ESBLs), AmpC and carbapenemase genes. The identified genes were sequenced and the variants determined.

Results

All in all, 96.5 % of P. aeruginosa isolates were susceptible to C/T, comparable to the susceptibilities of meropenem-vaborbactam (MVB = 96.5 %), imipenem/relebactam (IMI/REL = 96.9 %) and ceftazidime-avibactam (C/A = 97.0 %). MIC₅₀ and MIC₉₀ for C/T were 0.5 and 2 mg/L respectively against the 717 isolates. Among the 242 isolates (33.7 %) resistant to at least one anti-Pseudomonas β-lactam, close to 90 % were susceptible to C/T, C/A, MVB and IMI/REL. Among the 80 isolates resistant to piperacillin-tazobactam, cefepime and ceftazidime, 76.3 % were susceptible to C/T and only IMI/REL and amikacin reached susceptibility exceeding 80 %. Among the 32 isolates resistant to imipenem and meropenem, susceptibility exceeding 60 % was observed only for IMI/REL, C/T, and C/A. For these strains, the MIC₅₀ of C/T was 2 mg/L, while that of C/A was at the resistance threshold (8 mg/L). IMI/REL had the strongest activity (72 %) against the 25 isolates resistant to C/T. Lastly, 53 imipenem and/or C/T-R isolates harbored a class C β-lactam (blaPDC) variant, and one of them also carried the bla_PER-1 gene and another, the bla_VIM-2 gene.