34. Xác định hiệu quả phối hợp in vitro của ceftazidime/avibactam và meropenem trên các chủng klebsiella pneumoniae kháng carbapenem
Nội dung chính của bài viết
Tóm tắt
Thử nghiệm đánh giá hiệu quả phối hợp ceftazidime/avibactam và meropenem bằng phương pháp checkerboard trên 198 chủng K. pneumoniae kháng carbapenem cho thấy 48,5% (96/198) chủng có tương tác hiệp đồng và 51,5% (102/198) chủng có tương tác không khác biệt. Ở nhóm chủng có tương tác hiệp đồng, MIC90 trong phối hợp của ceftazidime/avibactam giảm 8 lần trong khi MIC90 của meropenem giảm được 128 lần. Ở nhóm có tương tác không khác biệt, MIC90 ceftazidime/avibactam vẫn giảm nhiều (> 16 lần) dù MIC meropenem không thay đổi đáng kể. Kết quả nghiên cứu cho thấy phối hợp ceftazidime/avibactam và meropenem là lựa chọn tiềm năng trong điều trị các chủng K. pneumoniae kháng carbapenem.
Chi tiết bài viết
Từ khóa
Klebsiella pneumoniae, kháng carbapenem, ceftazidime/avibactam, meropenem
Tài liệu tham khảo
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11. Mikhail S, Singh NB, Kebriaei R, et al. Evaluation of the Synergy of Ceftazidime-Avibactam in Combination with Meropenem, Amikacin, Aztreonam, Colistin, or Fosfomycin against Well-Characterized Multidrug-Resistant Klebsiella pneumoniae and Pseudomonas aeruginosa. Antimicrobial Agents and Chemotherapy. 2019; 63(8): 10.1128/aac.00779-19. doi:10.1128/aac.00779-19.
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2. World Health Organization. WHO Bacterial Priority Pathogens List, 2024: Bacterial Pathogens of Public Health Importance, to Guide Research, Development, and Strategies to Prevent and Control Antimicrobial Resistance. World Health Organization; 2024.
3. Logan LK, Weinstein RA. The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace. The Journal of Infectious Diseases. 2017; 215(suppl_1): S28-S36. doi:10.1093/infdis/jiw282.
4. Phạm Hồng Nhung, Nguyễn Tuấn Linh. Nhiễm trùng do các trực khuẩn Gram âm thường gặp tại Trung tâm Hồi sức tích cực, Bệnh viện Bạch Mai năm 2023. Tạp chí Nghiên cứu Y học. 2024; 178(5): 43-51. doi:10.52852/tcncyh.v178i5.2401.
5. Shields RK, Nguyen MH, Chen L, Press EG, Kreiswirth BN, Clancy CJ. Pneumonia and Renal Replacement Therapy Are Risk Factors for Ceftazidime-Avibactam Treatment Failures and Resistance among Patients with Carbapenem-Resistant Enterobacteriaceae Infections. Antimicrobial Agents and Chemotherapy. 2018; 62(5): 10.1128/aac.02497-17. doi:10.1128/aac.02497-17.
6. Shields RK, Chen L, Cheng S, et al. Emergence of Ceftazidime-Avibactam Resistance Due to Plasmid-Borne blaKPC-3 Mutations during Treatment of Carbapenem-Resistant Klebsiella pneumoniae Infections. Antimicrobial Agents and Chemotherapy. 2017; 61(3): 10.1128/aac.02097-16. doi:10.1128/aac.02097-16.
7. Assefa GM, Roberts JA, Aslan AT, Mohammed SA, Sime FB. A systematic review and individual bacterial species level meta-analysis of in vitro studies on the efficacy of ceftazidime/avibactam combined with other antimicrobials against carbapenem-resistant Gram-negative bacteria. Journal of Antimicrobial Chemotherapy. 2025; 80(2): 334-346. doi:10.1093/jac/dkae451.
8. Kuai J, Zhang Y, Lu B, et al. In vitro Synergistic Activity of Ceftazidime-Avibactam in Combination with Aztreonam or Meropenem Against Clinical Enterobacterales Producing blaKPC or blaNDM. IDR. 2023; 16:3171-3182. doi:10.2147/IDR.S408228.
9. Wu Yun, Yu Wei, Chu Xiaobing, et al. Effect of ceftazidime-avibactam combined with different antimicrobials against carbapenem-resistant Klebsiella pneumoniae. Microbiology Spectrum. 2024; 12(6): e00107-24. doi:10.1128/spectrum.00107-24.
10. Zheng M, Li FH, Liu J, et al. Synergistic effects of ceftazidime/avibactam combined with meropenem in a murine model of infection with KPC-producing Klebsiella pneumoniae. Journal of Antimicrobial Chemotherapy. 2024; 79(5): 1069-1080. doi:10.1093/jac/dkae074.
11. Mikhail S, Singh NB, Kebriaei R, et al. Evaluation of the Synergy of Ceftazidime-Avibactam in Combination with Meropenem, Amikacin, Aztreonam, Colistin, or Fosfomycin against Well-Characterized Multidrug-Resistant Klebsiella pneumoniae and Pseudomonas aeruginosa. Antimicrobial Agents and Chemotherapy. 2019; 63(8): 10.1128/aac.00779-19. doi:10.1128/aac.00779-19.
12. Clinical and Laboratory Standards Institute. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically: approved standard. CLSI document M07-A10. Published online 2015.
13. Clinical Microbiology Procedures Handbook. 4th edition. ASM Press Washington, DC; 2016.
14. Clinical and Laboratory Standards Institute, Wayne, PA. Performance Standards for Antimicrobial Susceptibility Testing. Vol CLSI supplement M100. 34th ed. Clinical and Laboratory Standards Institute; 2024.
15. Shen Z, Ding B, Ye M, et al. High ceftazidime hydrolysis activity and porin OmpK35 deficiency contribute to the decreased susceptibility to ceftazidime/avibactam in KPC-producing Klebsiella pneumoniae. Journal of Antimicrobial Chemotherapy. 2017; 72(7): 1930-1936. doi:10.1093/jac/dkx066.