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Activity of ceftazidime-avibactam against Escherichia coli isolates from U.S. veterans (2011) in relation to co-resistance and sequence type 131 (ST131) H30 and H30Rx status.
Diagnostic Microbiology and Infectious Disease ( IF 2.9 ) Pub Date : 2020-03-10 , DOI: 10.1016/j.diagmicrobio.2020.115034
Brian D Johnston 1 , Paul D Thuras 1 , James R Johnson 1
Affiliation  

Escherichia coli ST131, with its multidrug-resistance-associated H30R1 and H30Rx clonal subsets within the H30R subclone, causes most antimicrobial-resistant E. coli infections. The activity of ceftazidime-avibactam (CZA) against ST131 strains is undefined. We determined CZA MICs for 595 E. coli clinical isolates from 24 Veterans Affairs Medical Centers (2010-2011). Resistance status and MICs were compared with study resistance category (fluoroquinolone-susceptible, fluoroquinolone-resistant, and extended-spectrum beta-lactamase (ESBL)-producing); ST131, H30R1, and H30Rx status; blaCTX-M-15-like genotype; and MICs for piperacillin-tazobactam, levofloxacin, gentamicin, ceftazidime, and meropenem. Proportion resistant ranged from zero (CZA, meropenem) to 61% (levofloxacin). MICs generally increased by resistance category (from fluoroquinolone-susceptible through fluoroquinolone-resistant to ESBL), clonal subgroup (from non-ST131-H30 through H30R1 to H30Rx), and blaCTX-M-15-like status. CZA MICs were slightly but significantly greater in association with resistance (or elevated MICs) to each comparator yet remained in the susceptible range. CZA was reliably active and outperformed noncarbapenem comparators, so it should prove useful as a carbapenem-sparing alternative.

中文翻译:

头孢他啶-阿维巴坦对来自美国退伍军人 (2011) 的大肠杆菌分离株的活性与共抗性和序列类型 131 (ST131) H30 和 H30Rx 状态有关。

大肠杆菌 ST131 在 H30R 亚克隆中具有与多药耐药相关的 H30R1 和 H30Rx 克隆亚群,导致大多数抗微生物大肠杆菌感染。头孢他啶-阿维巴坦 (CZA) 对 ST131 菌株的活性是不确定的。我们确定了来自 24 个退伍军人事务医疗中心 (2010-2011) 的 595 种大肠杆菌临床分离株的 CZA MIC。将耐药状态和 MIC 与研究耐药类别(氟喹诺酮敏感、氟喹诺酮耐药和产生超广谱 β-内酰胺酶 (ESBL))进行比较;ST131、H30R1 和 H30Rx 状态;blaCTX-M-15 样基因型;哌拉西林-他唑巴坦、左氧氟沙星、庆大霉素、头孢他啶和美罗培南的 MIC。比例抗性范围从零(CZA,美罗培南)到 61%(左氧氟沙星)。MIC 通常按耐药类别(从氟喹诺酮敏感到氟喹诺酮对 ESBL 耐药)、克隆亚组(从非 ST131-H30 到 H30R1 到 H30Rx)和 blaCTX-M-15 样状态而增加。CZA MIC 与对每个比较剂的耐药性(或 MIC 升高)相关联,但显着增加,但仍处于易感范围内。CZA 具有可靠的活性并且优于非碳青霉烯类比较剂,因此它应该被证明可作为一种保留碳青霉烯类药物的替代品。
更新日期:2020-04-20
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