Antimicrobials as Single and Combination Therapy for Colistin-ResistantPseudomonas aeruginosaat a University Hospital in Thailand
Antimicrobials as Single and Combination Therapy for Colistin-ResistantPseudomonas aeruginosaat a University Hospital in Thailand
复制标题
DOI：
10.3390/antibiotics9080475
复制
发表时间：
2020-08-01
影响因子：
4.8
通讯作者：
Santimaleeworagun, Wichai
中科院分区：
文献类型：
--
作者：
Pungcharoenkijkul, Supanun;Traipattanakul, Jantima;Santimaleeworagun, Wichai
粘菌素耐药铜绿假单胞菌（CoR-PA）的全球感染正在增加;目前很少有研究关注CoR-PA分离株的抗菌药物敏感性，泰国没有。在这里，我们通过对CoR-PA临床分离株的体外试验，研究了各种抗菌剂单独使用和联合使用的影响。从2010年1月至2019年6月在Phramongkutklao医院接受治疗的患者中获得了18株CoR-PA分离株;通过使用肠细菌重复基因间共有序列（ERIC）-PCR方法将其分为6种不同的克隆类型，A组的患病率较高（27.8%）。使用ε-试验（E-test）方法将抗菌药物敏感性确定为最小抑菌浓度（MIC）。通过抑菌分数浓度指数报告了6种抗菌剂组合的协同活性。所有CoR-PA分离株对阿米卡星、美罗培南和头孢洛扎/他唑巴坦均敏感，但仅5.56%对亚胺培南敏感。阿米卡星与氨曲南、哌拉西林/他唑巴坦、美罗培南和头孢他啶的体外协同活性分别为16.67%、11.11%、11.11%和5.55%。1株CoR-PA分离株携带bla（Vim）金属β-内酰胺酶基因;无1株携带mcr-1基因或检出质粒介导的AmpC β-内酰胺酶或染色体AmpC β-内酰胺酶过量。7株（38.89%）CoR-PA具有生物被膜形成能力。总之，CoR-PA分离株对抗菌药物高度敏感;应在临床环境中检查对各种药物的反应中观察到的协同作用。
Global infections with colistin-resistantPseudomonas aeruginosa(CoR-PA) are increasing; there are currently very few studies focused on the antimicrobial susceptibility of CoR-PA isolates, and none from Thailand. Here, we investigated the impact of various antimicrobials, alone and in combination, via the in vitro testing of CoR-PA clinical isolates. Eighteen CoR-PA isolates were obtained from patients treated at Phramongkutklao Hospital from January 2010 through June 2019; these were classified into six different clonal types by using the enterobacterial repetitive intergenic consensus (ERIC)-PCR method, with a high prevalence of Group A (27.8%). The antimicrobial susceptibility was determined as the minimal inhibitory concentrations (MICs) using the epsilometer-test (E-test) method. The synergistic activities of six antimicrobial combinations were reported via the fractional-inhibitory-concentration index. All CoR-PA isolates were susceptible to amikacin, meropenem, and ceftolozane/tazobactam, but only 5.56% were susceptible to imipenem. In vitro synergistic activities were detected for amikacin with aztreonam, piperacillin/tazobactam, meropenem, and ceftazidime for 16.67%, 11.11%, 11.11%, and 5.55%, respectively. One CoR-PA isolate carried thebla(VIM)metallo-beta-lactamase gene; none carriedmcr-1genes or detected plasmid-mediated AmpC beta-lactamase or an overproduction of chromosomal AmpC beta-lactamase. Seven CoR-PA isolates (38.89%) were capable of biofilm formation. In conclusion, CoR-PA isolates are highly susceptible to antimicrobials; the synergy observed in response to the various agents should be examined in a clinical setting.