PDF(Pubmed)
Abstract：
With the increasing burden of carbapenem-resistant Klebsiella pneumoniae (CR-Kp), including high rates of healthcare-associated infections, treatment failure, and mortality, a good therapeutic strategy for attacking this multi-resistant pathogen is one of the main goals in current medical practice and necessitates the use of novel antibiotics or new drug combinations.
OBJECTIVE: We reviewed the clinical and microbiological outcomes of seven patients treated at the \"Agrippa Ionescu\" Clinical Emergency Hospital between October 2023 and January 2024, aiming to demonstrate the synergistic activity of the ceftazidime-avibactam (C/A) plus aztreonam (ATM) combination against the co-producers of blaNDM + blaOXA-48-like CR-Kp.
METHODS: Seven CR-Kp with blaNDM and blaOXA-48 as resistance mechanisms were tested. Seven patients treated with C/A + ATM were included. The synergistic activity of C/A + ATM was proven through double-disk diffusion in all seven isolates. Resistance mechanisms like KPC, VIM, OXA-48, NDM, IMP, and CTX-M were assessed through immunochromatography.
RESULTS: With a mean of nine days of treatment with the synergistic combination C/A + ATM, all patients achieved clinical recovery, and five achieved microbiological recovery.
CONCLUSIONS: With the emerging co-occurrence of blaOXA-48 and blaNDM among Kp in Romania, the combination of C/A and ATM could be a promising therapeutic option.
OBJECTIVE: We reviewed the clinical and microbiological outcomes of seven patients treated at the \"Agrippa Ionescu\" Clinical Emergency Hospital between October 2023 and January 2024, aiming to demonstrate the synergistic activity of the ceftazidime-avibactam (C/A) plus aztreonam (ATM) combination against the co-producers of blaNDM + blaOXA-48-like CR-Kp.
METHODS: Seven CR-Kp with blaNDM and blaOXA-48 as resistance mechanisms were tested. Seven patients treated with C/A + ATM were included. The synergistic activity of C/A + ATM was proven through double-disk diffusion in all seven isolates. Resistance mechanisms like KPC, VIM, OXA-48, NDM, IMP, and CTX-M were assessed through immunochromatography.
RESULTS: With a mean of nine days of treatment with the synergistic combination C/A + ATM, all patients achieved clinical recovery, and five achieved microbiological recovery.
CONCLUSIONS: With the emerging co-occurrence of blaOXA-48 and blaNDM among Kp in Romania, the combination of C/A and ATM could be a promising therapeutic option.
摘要：
随着耐碳青霉烯类肺炎克雷伯菌(CR-Kp)负担的增加,包括与医疗保健相关的高感染率，治疗失败,和死亡率，攻击这种多重耐药病原体的良好治疗策略是当前医学实践的主要目标之一,因此需要使用新型抗生素或新的药物组合.
目的：我们回顾了2023年10月至2024年1月在“AgrippaIonescu”临床急诊医院接受治疗的7例患者的临床和微生物学结果，旨在证明头孢他啶-阿维巴坦（C/A）加氨曲南（ATM）组合对blaNDM-blaOXA-48样Kp的共同生产者的协同活性。
方法：测试了以blaNDM和blaOXA-48为抗性机制的7种CR-Kp。包括7例用C/A+ATM治疗的患者。C/A+ATM的协同活性通过双盘扩散在所有七个分离株中得到证实。抵抗机制，如KPC，VIM,OXA-48,NDM,IMP,和CTX-M通过免疫层析进行评估。
结果：使用协同组合C/A+ATM平均治疗9天，所有患者均达到临床康复，五个实现了微生物回收。
结论：随着罗马尼亚Kp中blaOXA-48和blaNDM的出现，C/A和ATM的组合可能是一个有前途的治疗选择。
目的：我们回顾了2023年10月至2024年1月在“AgrippaIonescu”临床急诊医院接受治疗的7例患者的临床和微生物学结果，旨在证明头孢他啶-阿维巴坦（C/A）加氨曲南（ATM）组合对blaNDM-blaOXA-48样Kp的共同生产者的协同活性。
方法：测试了以blaNDM和blaOXA-48为抗性机制的7种CR-Kp。包括7例用C/A+ATM治疗的患者。C/A+ATM的协同活性通过双盘扩散在所有七个分离株中得到证实。抵抗机制，如KPC，VIM,OXA-48,NDM,IMP,和CTX-M通过免疫层析进行评估。
结果：使用协同组合C/A+ATM平均治疗9天，所有患者均达到临床康复，五个实现了微生物回收。
结论：随着罗马尼亚Kp中blaOXA-48和blaNDM的出现，C/A和ATM的组合可能是一个有前途的治疗选择。
