PDF(Pubmed)
Abstract：
UNASSIGNED: Due to the growing resistance to routinely used antibiotics, the search for new antibiotics or their combinations with effective inhibitors against multidrug-resistant microorganisms is ongoing. In our study, we assessed the in vitro drug susceptibility of Klebsiella pneumoniae strains producing New Delhi metallo-β-lactamases (NDM) to antibiotics included in the Infectious Diseases Society of America (IDSA) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) recommendations.
UNASSIGNED: A total of 60 strains of NDM-producing K. pneumoniae were obtained from different patients hospitalized at the 4th Military Hospital in Wroclaw between 2019 and 2022 and subjected to drug susceptibility to selected antibiotics, including the effects of drug combinations.
UNASSIGNED: Among the tested antibiotics, the highest sensitivity (100%) was observed for cefiderocol, eravacycline (interpreted according to the European Committee on Antimicrobial Susceptibility Testing [EUCAST]), and tigecycline. Sensitivity to intravenous fosfomycin varied depending on the method used. Using the \"strip stacking\" method, determining cumulative sensitivity to ceftazidime/avibactam and aztreonam demonstrated 100% in vitro sensitivity to this combination among the tested strains.
UNASSIGNED: The in vitro susceptibility assessment demonstrated that, the best therapeutic option for treating infections caused by carbapenemase-producing strains seems to be a combination of ceftazidime/avibactam with aztreonam. Due to the safety of using both drugs, cost effectiveness, and the broadest indications for use among the tested antibiotics, this therapy should be the first-line treatment for carbapenemase-producing Enterobacterales infections. Nevertheless, a comprehensive evaluation of the efficacy of treating infections caused by NDM-producing K. pneumoniae strains should include not only in vitro susceptibility assessment but also an analysis of clinical cases.
UNASSIGNED: A total of 60 strains of NDM-producing K. pneumoniae were obtained from different patients hospitalized at the 4th Military Hospital in Wroclaw between 2019 and 2022 and subjected to drug susceptibility to selected antibiotics, including the effects of drug combinations.
UNASSIGNED: Among the tested antibiotics, the highest sensitivity (100%) was observed for cefiderocol, eravacycline (interpreted according to the European Committee on Antimicrobial Susceptibility Testing [EUCAST]), and tigecycline. Sensitivity to intravenous fosfomycin varied depending on the method used. Using the \"strip stacking\" method, determining cumulative sensitivity to ceftazidime/avibactam and aztreonam demonstrated 100% in vitro sensitivity to this combination among the tested strains.
UNASSIGNED: The in vitro susceptibility assessment demonstrated that, the best therapeutic option for treating infections caused by carbapenemase-producing strains seems to be a combination of ceftazidime/avibactam with aztreonam. Due to the safety of using both drugs, cost effectiveness, and the broadest indications for use among the tested antibiotics, this therapy should be the first-line treatment for carbapenemase-producing Enterobacterales infections. Nevertheless, a comprehensive evaluation of the efficacy of treating infections caused by NDM-producing K. pneumoniae strains should include not only in vitro susceptibility assessment but also an analysis of clinical cases.
摘要：
■由于对常规使用的抗生素的耐药性不断增加，目前正在寻找新的抗生素或其与针对多药耐药微生物的有效抑制剂的组合。在我们的研究中,我们评估了产生新德里金属β-内酰胺酶(NDM)的肺炎克雷伯菌菌株对美国传染病学会(IDSA)和欧洲临床微生物学和传染病学会(ESCMID)推荐的抗生素的体外药物敏感性.
■从2019年至2022年在弗罗茨瓦夫第四军医院住院的不同患者中获得了60株产生NDM的肺炎克雷伯菌，并对某些抗生素进行了药物敏感性。包括药物组合的影响。
■在测试的抗生素中，最高的灵敏度（100％）是观察到头孢地洛，埃拉环素（根据欧洲抗菌药物敏感性试验委员会[EUCAST]解释），还有替加环素.对静脉内磷霉素的敏感性取决于所使用的方法。使用“条带堆叠”方法，确定对头孢他啶/阿维巴坦和氨曲南的累积敏感性表明，在测试菌株中，该组合的体外敏感性为100％。
■体外易感性评估表明，治疗由产生碳青霉烯酶的菌株引起的感染的最佳治疗选择似乎是头孢他啶/阿维巴坦与氨曲南的组合。由于使用这两种药物的安全性，成本效益，以及在测试的抗生素中使用的最广泛的适应症，这种疗法应该是产生碳青霉烯酶的肠杆菌感染的一线治疗.然而，对由产生NDM的肺炎克雷伯菌引起的感染的疗效的综合评估不仅应包括体外药敏评估,还应包括对临床病例的分析.
■从2019年至2022年在弗罗茨瓦夫第四军医院住院的不同患者中获得了60株产生NDM的肺炎克雷伯菌，并对某些抗生素进行了药物敏感性。包括药物组合的影响。
■在测试的抗生素中，最高的灵敏度（100％）是观察到头孢地洛，埃拉环素（根据欧洲抗菌药物敏感性试验委员会[EUCAST]解释），还有替加环素.对静脉内磷霉素的敏感性取决于所使用的方法。使用“条带堆叠”方法，确定对头孢他啶/阿维巴坦和氨曲南的累积敏感性表明，在测试菌株中，该组合的体外敏感性为100％。
■体外易感性评估表明，治疗由产生碳青霉烯酶的菌株引起的感染的最佳治疗选择似乎是头孢他啶/阿维巴坦与氨曲南的组合。由于使用这两种药物的安全性，成本效益，以及在测试的抗生素中使用的最广泛的适应症，这种疗法应该是产生碳青霉烯酶的肠杆菌感染的一线治疗.然而，对由产生NDM的肺炎克雷伯菌引起的感染的疗效的综合评估不仅应包括体外药敏评估,还应包括对临床病例的分析.
