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Abstract：
Background In the era of increased antimicrobial resistance, there are limited therapeutic options available for the treatment of bacteremia caused by multidrug-resistant organisms (MDROs). This study aims to find out the feasibility of using ceftazidime/avibactam (CZA) as a therapeutic option for bloodstream infections caused by multidrug-resistant (MDR) Enterobacterales and Pseudomonas aeruginosa based on its susceptibility profile. Materials and methods The isolates were routinely subjected to antimicrobial susceptibility testing (AST) by an automated AST system (VITEK-2). Those isolates found as MDR (resistant to at least one drug for ≥3 antimicrobial classes) were tested against CZA by Kirby-Bauer\'s disk diffusion (kb-DD) method. Results A total number of 293 MDR Enterobacterales and 31 MDR P. aeruginosa isolates were included. Of these, 87.3% of isolates were found as carbapenem-resistant (CR), whereas 12.7% of isolates were found as carbapenem susceptible. About 30.6% of MDROs were susceptible to CZA. Among carbapenem-resistant organisms (CROs), CR Klebsiella pneumoniae(33.5%) is most susceptible to CZA, compared to CR P. aeruginosa(0%)and CREscherichia coli(3.2%). Among the MDR isolates that were susceptible to CZA (30.6%), the majority had poor susceptibility against other β-lactam-β-lactamase inhibitor (BL-BLI) agents. Among all antimicrobial agents tested against CROs, colistin (96%) was found to have the best susceptibility profile. Conclusion It is observed that CZA is an acceptable therapeutic option for the treatment of bacteremia caused by MDROs, especially CROs. Therefore, it is important for the laboratories to perform the AST for CZA if the healthcare settings intend to use CZA for the management of such \"difficult-to-treat\" bloodstream infections.
摘要：
背景技术在抗菌素耐药性增加的时代,对于多药耐药菌(MDROs)引起的菌血症的治疗选择有限.这项研究旨在根据多重耐药（MDR）肠杆菌和铜绿假单胞菌的敏感性，找出使用头孢他啶/阿维巴坦（CZA）作为治疗由多药耐药（MDR）肠杆菌和铜绿假单胞菌引起的血流感染的可行性。材料和方法通过自动化AST系统(VITEK-2)对分离物进行常规的抗微生物敏感性测试(AST)。通过Kirby-Bauer的圆盘扩散（kb-DD）方法对那些被发现为MDR（对至少一种≥3种抗菌药物具有抗性）的分离株进行了CZA测试。结果共纳入293株MDR肠杆菌和31株MDR铜绿假单胞菌。其中,87.3%的分离株被发现耐碳青霉烯（CR），而12.7％的分离株被发现是碳青霉烯类敏感。约30.6％的MDRO易感CZA。在耐碳青霉烯的生物体（CRO）中，CR肺炎克雷伯菌(33.5%)最易感CZA,与CR铜绿假单胞菌(0%)和大肠杆菌(3.2%)相比。在对CZA敏感的MDR分离株(30.6%)中，大多数患者对其他β-内酰胺-β-内酰胺酶抑制剂(BL-BLI)药物的敏感性较差.在针对CRO测试的所有抗菌剂中，发现粘菌素（96％）具有最佳的敏感性。结论观察到CZA是治疗MDROs引起的菌血症的可接受的治疗选择。尤其是CRO。因此,如果医疗机构打算使用CZA来管理这种"难以治疗"的血流感染,那么对于实验室来说,进行CZA的AST是非常重要的.
