头孢地洛尔体外抗囊性纤维化成人铜绿假单胞菌活性的研究。

Access microbiology Pub Date : 2025-09-19 eCollection Date: 2025-01-01 DOI:10.1099/acmi.0.001001.v3
Saied Ali, Sinead McDermott
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引用次数: 0

摘要

背景。铜绿假单胞菌是囊性纤维化(CF)的关键病原体,通过毒力因子和适应性突变驱动肺功能衰退并表现出耐药性。Cefiderocol (FDC)是一种具有抗革兰氏阴性菌活性的新型铁载体头孢菌素。我们的目的是评估FDC对CF人群中铜绿假单胞菌分离株的体外疗效。方法。该研究是在一家拥有成人CF专科服务的三级医院进行的。该队列中所有重要呼吸道病原体的首次分离株均在-80°C低温保存。根据欧洲抗微生物药敏试验委员会(第10版)对2017年至2022年(含2022年)所有保存的铜绿假单胞菌分离株进行FDC的抗微生物药敏试验。结果。纳入71例患者的85株分离株。耐药表型包括19% (n=16)多重耐药(MDR)、16% (n=14)广泛耐药(XDR)和24% (n=20)泛耐药(PDR),其中24% (n=20)表现为黏液样表型。总体而言,85%的分离株对FDC敏感,平均抑制带为25.2 mm。在81%的MDR、86%的XDR、60%的PDR和90%的粘液样分离物中保留了抗菌活性。美罗培尼不敏感的分离株中有74%对FDC敏感,而对头孢唑嗪-他唑巴坦(42%)、妥布霉素(36%)和环丙沙星(22%)的敏感性较低。结论。FDC对成年CF患者的铜绿假单胞菌表现出良好的体外活性,包括高抗性和粘液样表型。这些发现突出了其作为这一高危人群的救助选择的潜力,并提供了第一个爱尔兰监测数据,为抗菌药物管理和未来的临床使用提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
In vitro activity of cefiderocol against Pseudomonas aeruginosa isolated from adult patients with cystic fibrosis.

Background. Pseudomonas aeruginosa is a key pathogen in cystic fibrosis (CF), driving pulmonary decline and exhibiting resistance through virulence factors and adaptive mutations. Cefiderocol (FDC) is a novel siderophore cephalosporin with activity against Gram-negative bacteria. We aimed to assess the in vitro efficacy of FDC against P. aeruginosa isolates in a CF population. Methods. The study was conducted in a tertiary hospital with a specialist adult CF service. All first isolates of significant respiratory pathogens among this cohort are cryopreserved at -80 °C. Antimicrobial susceptibility testing to FDC was performed as per European Committee on Antimicrobial Susceptibility Testing Disk-Diffusion (version 10) for all stored isolates of P. aeruginosa from 2017 to 2022 inclusive. Results. Eighty-five isolates from seventy-one patients were included. Resistance phenotypes comprised 19% (n=16) multidrug-resistant (MDR), 16% (n=14) extensively drug-resistant (XDR) and 24% (n=20) pandrug-resistant (PDR), with 24 % (n=20) exhibiting the mucoid phenotype. Overall, 85% of isolates were susceptible to FDC, with a mean inhibition zone of 25.2 mm. Antimicrobial activity was retained in 81% of MDR, 86% of XDR, 60% of PDR and 90% of mucoid isolates. Seventy-four per cent of meropenem-non-susceptible isolates remained susceptible to FDC, compared with lower susceptibility to ceftolozane-tazobactam (42%), tobramycin (36%) and ciprofloxacin (22%). Conclusion. FDC exhibited excellent in vitro activity against P. aeruginosa from adults with CF, including highly resistant and mucoid phenotypes. These findings highlight its potential as a salvage option in this high-risk population and provide the first Irish surveillance data to inform antimicrobial stewardship and future clinical use.

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