氨曲南-阿维巴坦,eravacycline,和头孢瑟利是三种新型抗菌剂,用于治疗革兰氏阴性菌引起的严重感染。我们评估了上述三种抗微生物剂对临床肠杆菌分离株的体外活性。共有1,202株肠杆菌分离株,包括10个属或种,从覆盖中国七个地区的26家医院收集。根据美国食品和药物管理局和临床和实验室标准研究所指南的组合,对30种抗微生物剂的敏感性进行了解释。结果表明,肠杆菌对氨曲南-阿维巴坦的敏感性较高(98.25%),埃拉环素(85.69%),和塞福斯(62.73%)。前两种抗微生物剂还表现出针对多重耐药和碳青霉烯耐药肠杆菌的有效活性,而与抗微生物耐药机制无关。氨曲南-阿维巴坦的敏感率,eravacycline,和头孢瑟利在摩根氏菌属中最低。(84.42%),变形杆菌。(33.65%),和大肠杆菌(40.14%),分别。总的来说,老年住院组患者对埃拉环素和头孢司利的敏感性较低.尿路分离菌株对埃拉环素的敏感率最低(78.97%),在神经系统标本中观察到对头孢瑟利的敏感性最低(45.83%)。与从非ICU病房分离的菌株相比,从重症监护病房(ICU)病房分离的菌株对头孢瑟利的易感性显着降低。氨曲南-阿维巴坦和头孢他啶-阿维巴坦的MIC值一致性较差(加权κ=0.243),埃拉环素和替加环素也是如此(加权kappa=0.478)。头孢噻利和头孢吡肟对肠杆菌表现出高度相似的活性(加权κ=0.801)。我们的结果支持氨曲南-阿维巴坦的临床发展,eravacycline,和头孢瑟利治疗由肠杆菌引起的感染。重要性由多药耐药(MDR)肠杆菌引起的感染,尤其是耐碳青霉烯类肠杆菌(CRE),由于治疗选择有限,一直是一个具有挑战性的临床问题。因此,迫切需要开发新的抗微生物剂并评估其体外抗肠杆菌的活性。我们的结果表明,新型抗菌剂氨曲南-阿维巴坦和埃拉环素保留了对MDR和CRE分离株的活性,包括碳青霉烯酶生产者和非碳青霉烯酶生产者。进一步分析结合所测试菌株的临床信息显示,具有不同人口统计学参数的菌株对氨曲南-阿维巴坦的敏感性没有显着差异。年龄,标本来源,和部门与菌株对埃拉环素和头孢瑟利的敏感性相关(P≤0.01)。与头孢他啶-阿维巴坦相比,氨曲南-阿维巴坦对肠杆菌有其优点和局限性。埃拉环素对肠杆菌的有效活性高于替加环素。头孢噻利和头孢吡肟对肠杆菌表现出高度一致的活性。
Aztreonam-avibactam, eravacycline, and cefoselis are three novel antimicrobial agents for the treatment of serious infections caused by Gram-negative bacteria. We evaluated the in vitro activities of the above-mentioned three antimicrobial agents against clinical Enterobacterales isolates. A total of 1,202 Enterobacterales isolates, including 10 genera or species, were collected from 26 hospitals that cover seven regions of China. The susceptibilities of the 30 antimicrobial agents were interpreted based on the combination of U.S. Food and Drug Administration and Clinical and Laboratory Standards Institute guidelines. The results indicated that all Enterobacterales isolates showed high susceptibility to
aztreonam-avibactam (98.25%), eravacycline (85.69%), and cefoselis (62.73%). The first two antimicrobial agents also demonstrated potent activities against multidrug-resistant and carbapenem-resistant Enterobacterales independent of antimicrobial resistance mechanisms. The rates of susceptibility to
aztreonam-avibactam, eravacycline, and cefoselis were lowest in Morganella spp. (84.42%), Proteus spp. (33.65%), and Escherichia coli (40.14%), respectively. In general, the lower rates of susceptibility to eravacycline and cefoselis were in the older inpatient group. The strains isolated from urinary tract exhibited the lowest rate of susceptibility (78.97%) to eravacycline, and the lowest rate of susceptibility (45.83%) to cefoselis was observed in nervous system specimens. The strains isolated from intensive care unit (ICU) wards showed significantly reduced susceptibility to cefoselis compared with those isolated from non-ICU wards. The MIC values of
aztreonam-avibactam and ceftazidime-avibactam have poor consistency (weighted kappa = 0.243), as did eravacycline and tigecycline (weighted kappa = 0.478). Cefoselis and cefepime showed highly similar activities against Enterobacterales (weighted kappa = 0.801). Our results support the clinical development of
aztreonam-avibactam, eravacycline, and cefoselis to treat infections caused by Enterobacterales. IMPORTANCE Infections caused by multidrug-resistant (MDR) Enterobacterales, especially carbapenem-resistant Enterobacterales (CRE), have been a challenging clinical problem due to the limited therapeutic options. Therefore, the need to develop novel antimicrobial agents and evaluate their activities against Enterobacterales in vitro is urgent. Our results show that the novel antimicrobial agents aztreonam-avibactam and eravacycline retain activities against MDR and CRE isolates, including carbapenemase producers and non-carbapenemase producers. Further analysis combined with clinical information on the strains tested revealed that no significant differences were observed in susceptibility rates of strains with different demographic parameters to aztreonam-avibactam. Age, specimen source, and department were associated with the susceptibility of strains to eravacycline and cefoselis (P ≤ 0.01). Compared with ceftazidime-avibactam, aztreonam-avibactam has its advantages and limitations against Enterobacterales. The potent activity of eravacycline against Enterobacterales was higher than that of tigecycline. Cefoselis and cefepime showed a highly consistent activity against Enterobacterales.