Abstract:
The rapid emergence of multi-drug resistant Gram-negative pathogens has driven the introduction of novel β-lactam combination agents (BLCs) to the antibiotic market: ceftolozane-tazobactam, ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, cefiderocol, and sulbactam-durlobactam. These agents are equipped with innovative mechanisms that confer broad Gram-negative activity, notably against certain challenging carbapenemases. While their introduction offers a beacon of hope, clinical microbiology laboratories must navigate the complexities of susceptibility testing for these agents due to their diverse activity profiles against specific β-lactamases and the possibility of acquired resistance mechanisms in some bacterial isolates. This review explores the complexities of these novel antimicrobial agents detailing the intricacies of their application, providing guidance on the nuances of susceptibility testing, interpretation, and result reporting in clinical microbiology laboratories.
摘要:
多药耐药革兰氏阴性病原体的迅速出现推动了新型β-内酰胺联合药物(BLC)向抗生素市场的引入:头孢特洛赞-他唑巴坦,头孢他啶-阿维巴坦,美罗培南-瓦巴坦,亚胺培南-莱巴坦,cefiderocol,还有舒巴坦-杜洛巴坦.这些药物配备了创新机制,赋予广泛的革兰氏阴性活性,特别是针对某些具有挑战性的碳青霉烯酶。虽然他们的介绍提供了希望的灯塔,由于这些药物对特定β-内酰胺酶的不同活性谱以及某些细菌分离株的获得性耐药机制的可能性,临床微生物学实验室必须应对这些药物敏感性测试的复杂性.这篇综述探讨了这些新型抗菌剂的复杂性,详细说明了它们的应用的复杂性,提供有关敏感性测试细微差别的指导,解释,以及临床微生物学实验室的结果报告。