Existing data support the combination of aztreonam and ceftazidime–avibactam against serine-β-lactamase (SBL)– and metallo-β-lactamase (MBL)–producing Enterobacterales, although there is a paucity of data against SBL- and MBL-producing Pseudomonas aeruginosa. In this study, 5 SBL- and MBL-producing P. aeruginosa (1 IMP, 4 VIM) were evaluated against aztreonam and ceftazidime–avibactam alone and in combination via broth microdilution and time-kill analyses. All 5 isolates were nonsusceptible to aztreonam, aztreonam–avibactam, and ceftazidime–avibactam. Combining aztreonam with ceftazidime–avibactam at subinhibitory concentrations produced synergy and restored bactericidal activity in 4/5 (80%) isolates tested. These results suggest that the combination of aztreonam and ceftazidime–avibactam may be a viable treatment option against SBL- and MBL-producing P. aeruginosa.

现有数据支持氨曲南和头孢他啶-阿维巴坦联合抗产丝氨酸-β-内酰胺酶（SBL）和产金属-β-内酰胺酶（MBL）的肠杆菌，尽管缺乏针对SBL和MBL产铜绿假单胞菌的数据。。在这项研究中，产生了5个SBL和MBL的铜绿假单胞菌（1 IMP，4 VIM）分别通过肉汤微量稀释和时间杀伤分析对氨曲南和头孢他啶-阿维巴坦进行了评估。所有5种分离物均不敏感于氨曲南，氨曲南-avibactam和头孢他啶-avibactam。在抑制下浓度下，将氨曲南与头孢他啶-avibactam联合使用可产生协同作用，并在4/5（80％）分离株中恢复了杀菌活性。这些结果表明，氨曲南和头孢他啶-阿维巴坦的组合可能是对抗产生SBL和MBL的铜绿假单胞菌的可行治疗选择。