Comparison of in vitro and in vivo antimicrobial activity of ceftazidime/avibactam alone or in combination with aztreonam against carbapenem-re-sistant Enterobacterales
10.12138/j.issn.1671-9638.20246028
- VernacularTitle:头孢他啶/阿维巴坦单用或与氨曲南联用对碳青霉烯类耐药肠杆菌目细菌的体内、外抗菌活性的比较
- Author:
Li-Juan BIAN
1
,
2
;
Jun-Zhe GUO
;
Mei-Juan ZHENG
Author Information
1. 安徽医科大学第一附属医院检验科,安徽 合肥 230022
2. 蚌埠第五人民医院检验科,安徽 蚌埠 233099
- Keywords:
ceftazidime/avibactam;
aztreonam;
carbapenem-resistant Enterobacterales;
antimicrobial activity
- From:
Chinese Journal of Infection Control
2024;23(10):1206-1212
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the in vivo and in vitro antimicrobial activity of ceftazidime/avibactam(CZA)alone or in combination with aztreonam(ATM)against carbapenem-resistant Enterobacterales(CRE),and provide evidence for clinical anti-infective therapy.Methods The minimum inhibitory concentrations(MICs)of CZA and ATM against 52 clinically isolated non-repetitive CRE strains in a hospital from 2018 to 2022 were deter-mined with microbroth dilution method,and the combined antimicrobial susceptibility testing was performed with the chessboard dilution method.Time-killing curve and Galleria mellonella infection model were used to test the bac-tericidal effect of CZA alone or in combination with ATM.Results Among the 23 KPC-producing CRE strains,91.3％(n=21)had MIC ≤ 4 μg/mL for CZA,and 8.7％(n=2)had MIC ≥128 μg/mL for CZA.MIC of CZA to 29 CRE strains(strains producing NDM,IMP,KPC+IMP,and KPC+NDM)were all ≥128 μg/mL.Of the 31 CZA-resistant strains,93.5％(n=29)strains had fractional inhibitory concentration(FIC)＜0.5 for combination of CZA and ATM,while 6.5％(n=2)had FIC of 0-1.The time-killing curve showed that CZA had bactericidal effect on KPC-producing strains,and CZA combined with ATM had bactericidal effect on CZA-resistant strains.Compared with the monotherapy group,CZA combined with ATM treatment significantly improved the survival rate of CRE-infected Galleria mellonella(median survival time 120 hour,P=0.001).Conclusion CZA has good antimi-crobial activity against KPC-producing bacteria.The combination of CZA and ATM had synergistic bacteriostatic effect on CZA-resistant strains.
