KPC-producing Klebsiella pneumoniae bloodstream isolates from Brazilian hospitals: What (still) remains active?
KPC-producing Klebsiella pneumoniae bloodstream isolates from Brazilian hospitals: What (still) remains active?
复制标题
DOI：
10.1016/j.jgar.2018.07.011
复制
发表时间：
2018-12-01
影响因子：
4.6
通讯作者：
Zavascki, Alexandre P.
中科院分区：
文献类型：
--
作者：
Antochevis, Laura C.;Magagnin, Cibele M.;Zavascki, Alexandre P.
目的：本研究根据巴西医院产kpc肺炎克雷伯菌（KPC-Kp）血液分离株的不同断点，评估了对多粘菌素B （PMB）和替代抗菌素的敏感性，重点是氨基糖苷类和替加环素。方法：选取巴西四家三级医院的三种碳青霉烯类药物（美罗培南、亚胺培南和厄他培南）均不敏感的肺炎克雷伯菌血液分离株。根据不同的断点确定和解释抗菌药物敏感性。选择29株耐药KPC-Kp进行分子分型。结果：共分析了158个KPC-Kp。PMB的MIC50/90值为0.25/16 mg/L；40株（25.3%）耐药；美罗培南的MIC50/90值为32/ >= 256 mg/L；CLSI结果显示，没有菌株对美罗培南敏感，但EUCAST断点显示，有10株菌株对美罗培南敏感（1,MIC = 4 mg/L; 9, MIC = 8 mg/L）。替加环素的MIC50/90值为2/ 8mg /L；根据EUCAST和FDA的断点，分别有53株（33.5%）和94株（59.5%）敏感。阿米卡星的MIC50/90值为32/ >= 64 mg/L，庆大霉素的MIC50/90值为>= 16/ >= 16 mg/L；CLSI、EUCAST和USCAST对阿米卡星敏感者分别为48人（30.4%）、28人（17.7%）和16人（10.1%），但对庆大霉素的敏感率分别为
Objectives: This study assessed susceptibility to polymyxin B (PMB) and alternative antimicrobials, with focus on aminoglycosides and tigecycline, according to different breakpoints in KPC-producing Klebsiella pneumoniae (KPC-Kp) bloodstream isolates from Brazilian hospitals.Methods: Bloodstream K. pneumoniae isolates non-susceptible to any of the three carbapenems (meropenem, imipenem or ertapenem) from four Brazilian tertiary-care hospitals were selected. Antimicrobial susceptibility was determined and interpreted according to distinct breakpoints. Twenty-nine PMB-resistant KPC-Kp isolates were selected for molecular typing.Results: A total of 158 KPC-Kp were analysed. MIC50/90 values for PMB were 0.25/16 mg/L; 40 isolates (25.3%) were resistant to PMB. MIC50/90 values for meropenem were 32/ >= 256 mg/L; no isolates were susceptible to meropenem according to CLSI, but 10 isolates were intermediate using EUCAST breakpoints (1, MIC = 4 mg/L; 9, MIC = 8 mg/L). MIC50/90 values for tigecycline were 2/8 mg/L; 53 (33.5%) and 94 (59.5%) isolates were susceptible according to EUCAST and FDA breakpoints, respectively. MIC50/90 values were 32/ >= 64 mg/L for amikacin and >= 16/ >= 16 mg/L for gentamicin; 48 (30.4%), 28 (17.7%) and 16 (10.1%) were susceptible to amikacin according to CLSI, EUCAST and USCAST, respectively, but susceptibility rates to gentamicin were