Comparative in vitro activity of carbapenems against major Gram-negative pathogens: results of Asia-Pacific surveillance from the COMPACT II study
Comparative in vitro activity of carbapenems against major Gram-negative pathogens: results of Asia-Pacific surveillance from the COMPACT II study
复制标题
DOI：
10.1016/j.ijantimicag.2012.01.002
复制
发表时间：
2012-04-01
影响因子：
10.8
通讯作者：
Davies, Todd
中科院分区：
文献类型：
--
作者：
Kiratisin, Pattarachai;Chongthaleong, Anan;Davies, Todd
在亚太区域，革兰氏阴性病原体的耐药率正在上升。碳青霉烯比较活性测试（COMPACT） II研究调查了2010年期间多利培南、亚胺培南和美罗培南对从5个亚太国家（新西兰、菲律宾、新加坡、泰国和越南）20个中心住院患者中分离的1260种主要革兰氏阴性病原体的碳青霉烯敏感性和最低抑制浓度（mic）。铜绿假单胞菌（n = 625）、肠杆菌科（n = 500）和其他革兰氏阴性病原体，包括鲍曼不动杆菌（n = 135），从血液感染（32.2%）、医院性肺炎（包括呼吸机相关性肺炎）（58.1%）和并发腹腔内感染（9.7%）的患者中收集，其中36.7%从重症监护病房的患者中分离。高达29.8%的铜绿假单胞菌（P. aeruginosa）和73.0%的鲍曼假单胞菌（a . baumannii）对至少一种碳青霉烯类不敏感，而大多数肠杆菌科（97.2%）对所有碳青霉烯类都敏感。多利培南、亚胺培南、美罗培南对铜绿假单胞菌的MIC50/MIC90值分别为0.38/8、1.5/32、0.38/16 mg/L；肠杆菌科为0.023/0.094、0.25/0.5和0.032/0.094 mg/L；鲍曼不动杆菌为32/64、32/128和32/64 mg/L。多利培南和美罗培南对铜绿假单胞菌具有相当的活性，两者都比亚胺培南更有活性。所有碳青霉烯类药物对肠杆菌科细菌都有很强的抑制作用，但亚胺培南的MIC值高于多利培南和美罗培南。3种碳青霉烯类对鲍曼不动杆菌的活性较弱。在重要的医院病原菌（铜绿假单胞菌和鲍曼假单胞菌）中碳青霉烯类耐药的高流行率要求在亚太地区采取严格的感染控制措施和适当的抗微生物药物使用。(C) 2012 Elsevier B.V.与International Society of Chemotherapy。版权所有。
Resistance rates amongst Gram-negative pathogens are increasing in the Asia-Pacific region. The Comparative Activity of Carbapenem Testing (COMPACT) II study surveyed the carbapenem susceptibility and minimum inhibitory concentrations (MICs) of doripenem, imipenem and meropenem against 1260 major Gram-negative pathogens isolated from hospitalised patients at 20 centres in five Asia-Pacific countries (New Zealand, the Philippines, Singapore, Thailand and Vietnam) during 2010. Pseudomonas aeruginosa (n = 625), Enterobacteriaceae (n = 500), and other Gram-negative pathogens including Acinetobacter baumannii (n = 135) were collected from patients with bloodstream infection (32.2%), nosocomial pneumonia including ventilator-associated pneumonia (58.1%), and complicated intra-abdominal infection (9.7%), with 36.7% being isolated from patients in an Intensive Care Unit. As high as 29.8% of P. aeruginosa and 73.0% of A. baumannii isolates were not susceptible to at least a carbapenem, whereas the majority of Enterobacteriaceae (97.2%) were susceptible to all carbapenems. Respective MIC50/MIC90 values (MICs for 50% and 90% of the organisms, respectively) of doripenem, imipenem and meropenem were: 0.38/8, 1.5/32 and 0.38/16 mg/L for P. aeruginosa; 0.023/0.094, 0.25/0.5 and 0.032/0.094 mg/L for Enterobacteriaceae; and 32/64, 32/128 and 32/64 mg/L for A. baumannii. Doripenem and meropenem had comparable activity against P. aeruginosa, both being more active than imipenem. All carbapenems were highly potent against Enterobacteriaceae, although imipenem demonstrated higher MIC values than doripenem and meropenem. The three carbapenems showed less activity against A. baumannii. The high prevalence of carbapenem resistance amongst important nosocomial pathogens (P. aeruginosa and A. baumannii) warrants rigorous infection control measures and appropriate antimicrobial use in the Asia-Pacific region. (C) 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.