摘要
目的评估依拉环素(ERV)与头孢他啶/阿维巴坦(CZA)对耐碳青霉烯类肺炎克雷伯菌(CRKP)的体外抗菌活性,为临床治疗CRKP感染提供参考依据。方法选取2024年1月至2025年1月北京中医药大学东方医院临床分离的CRKP菌株82株,应用VITEK MS质谱仪和VITEK 2全自动药敏分析仪对菌株进行鉴定及药敏分析。采用VITEK 2 AST-XN18药敏卡检测ERV和CZA的敏感性。采用胶体金免疫层析法检测CRKP的碳青霉烯酶酶型。结果82株CRKP菌株中,对ERV和CZA的耐药率分别为23.2%、32.9%,其中52.4%CRKP菌株对ERV和CZA同时敏感,8.5%CRKP菌株对ERV和CZA同时耐药。58株KPC酶型菌株中,ERV和CZA的耐药率分别为20.7%、10.3%;14株NDM酶型菌株中,ERV和CZA的耐药率分别为28.6%、100.0%;7株KPC+NDM双酶型菌株中,ERV的耐药率为42.9%,而CZA 100.0%耐药;1株产OXA-48酶和2株碳青霉烯酶阴性的CRKP对ERV和CZA均敏感。结论ERV和CZA对CRKP菌株均有很好的抑菌活性,但不同产酶类型的CRKP对这两种药物的体外抑菌效果存在显著差异。因此,临床治疗CRKP感染时,应根据其产酶类型合理选择抗菌药物。
Objective To evaluate the in vitro antibacterial activity of Eravacycline(ERV)and Ceftazidime/Avibactam(CZA)against Carbapenem-resistant Klebsiella pneumoniae(CRKP),and to provide a reference basis for the clinical treatment of CRKP infection.Methods A total of 82 CRKP strains isolated from clinical samples at Dongfang Hospital,Beijing University of Chinese Medicine from January 2024 to January 2025 were selected.The strains were identified and their drug susceptibility analyzed using the VITEK MS mass spectrometer and the VITEK 2 fully automatic drug susceptibility analyzer.The sensitivity of ERV and CZA was detected by using VITEK 2 AST-XN18 drug susceptibility cards.The enzyme type of carbapenemase in CRKP was detected by colloidal gold immunochromatography.Results Among the 82 CRKP strains,the resistance rates to ERV and CZA were 23.2%and 32.9%respectively.Among them,52.4%of the CRKP strains were sensitive to both ERV and CZA,while 8.5%of the strains were resistant to both ERV and CZA.Among the 58 KPC enzyme type strains,the resistance rates to ERV and CZA were 20.7%and 10.3%respectively;among the 14 NDM enzyme type strains,the resistance rates to ERV and CZA were 28.6%and 100.0%respectively;among the seven KPC+NDM double enzyme type strains,the resistance rate to ERV was 42.9%,while the resistance rate to CZA was 100.0%;one OXA-48 enzyme-producing strain and two carbapenemase-negative CRKP strains were all sensitive to ERV and CZA.Conclusion ERV and CZA both have excellent antibacterial activity against CRKP strains.However,there are significant differences in the in vitro antibacterial effects of these two drugs on different enzyme-producing types of CRKP.Therefore,when treating CRKP infections clinically,antimicrobial drugs should be selected rationally based on their enzyme-producing types.
作者
韩静
段学光
张省委
张可睿
李占稳
张静冉
吴连辉
杨明明
HAN Jing;DUAN Xueguang;ZHANG Shengwei;ZHANG Kerui;LI Zhanwen;ZHANG Jingran;WU Lianhui;YANG Mingming(Department of Clinical Laboratory,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Department of Oncology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)
出处
《中国医药导报》
2026年第4期33-37,共5页
China Medical Herald
基金
北京中医药大学青年教师项目(2018-JYBZZJS156)
北京中医药大学东方医院高水平能力建设项目(DFRCZY-2024JGYJ014)。
