Detection and Characterization of β-Lactamase Encoding Genes in Carbapenem Non-Susceptible Gram-Negative Bacteria and Susceptibility of Isolates to Ceftazidime-Avibactam at a New York City Community Hospital  

作　　者：Carl Urban Rita Colon-Urban Vincent J. LaBombardi Noriel Mariano Nishant Prasad Geeti Dhillon Marina Guralnik Sorana Segal-Maurer Carl Urban;Rita Colon-Urban;Vincent J. LaBombardi;Noriel Mariano;Nishant Prasad;Geeti Dhillon;Marina Guralnik;Sorana Segal-Maurer(The Dr. James J. Rahal, Jr. Division of Infectious Diseases, Department of Medicine, New York-Presbyterian/Queens, Flushing, NY, USA;The Dr. James J. Rahal, Jr. Division of Infectious Diseases, Department of Medicine, NewYork-Presbyterian/Queens, Flushing, NY, USA;Department of Biological Sciences, SUNY Old Westbury, Old Westbury, New York, NY, USA;Department of Pathology, NewYork-Presbyterian/Queens, Flushing, NY, USA)

机构地区：[1]The Dr. James J. Rahal, Jr. Division of Infectious Diseases, Department of Medicine, New York-Presbyterian/Queens, Flushing, NY, USA [1]The Dr. James J. Rahal, Jr. Division of Infectious Diseases, Department of Medicine, NewYork-Presbyterian/Queens, Flushing, NY, USA [2]Department of Biological Sciences, SUNY Old Westbury, Old Westbury, New York, NY, USA [3]Department of Pathology, NewYork-Presbyterian/Queens, Flushing, NY, USA

出　　处：《Open Journal of Medical Microbiology》2016年第4期150-157,共8页医学微生物学（英文）

摘　　要：A surveillance study was undertaken to identify prominent β-lactamase encoding genes in 131 carbapenem non-susceptible gram-negative clinical isolates at a New York City community hospital. KPC carbapenemases were detected in 89% of Enterobacteriaceae as well as additional TEM, SHV, and CTX-M class A enzymes. OXA-23 and OXA-24 were the prevalent class D carbapenemases identified in Acinetobacter species. One OXA-23 in M. morganii and one OXA-48 in K. pneumoniae were also identified. Among class C β-lactamases CMY, ACT/MIR, DHA, and FOX were detected. The in vitro activity of ceftazidime-avibactam by E-test methodology was tested with minimal inhibitory concentrations (MIC) of ≤3 μg/ml for 97.8% of all Enterobacteriaceae, MIC_50/90 of 16/>256 μg/ml for carbapenem non-susceptible Acinetobacter, and 3/6 μg/ml for carbapenem non-susceptible Pseudomonas aeruginosa. Periodic surveillance of isolates to characterize current and emerging β-lactamase genotypes present in local isolates may help identify outbreak situations, provide assistance to infection control and antibiotic stewardship programs, and potentially improve patient outcomes.A surveillance study was undertaken to identify prominent β-lactamase encoding genes in 131 carbapenem non-susceptible gram-negative clinical isolates at a New York City community hospital. KPC carbapenemases were detected in 89% of Enterobacteriaceae as well as additional TEM, SHV, and CTX-M class A enzymes. OXA-23 and OXA-24 were the prevalent class D carbapenemases identified in Acinetobacter species. One OXA-23 in M. morganii and one OXA-48 in K. pneumoniae were also identified. Among class C β-lactamases CMY, ACT/MIR, DHA, and FOX were detected. The in vitro activity of ceftazidime-avibactam by E-test methodology was tested with minimal inhibitory concentrations (MIC) of ≤3 μg/ml for 97.8% of all Enterobacteriaceae, MIC_50/90 of 16/>256 μg/ml for carbapenem non-susceptible Acinetobacter, and 3/6 μg/ml for carbapenem non-susceptible Pseudomonas aeruginosa. Periodic surveillance of isolates to characterize current and emerging β-lactamase genotypes present in local isolates may help identify outbreak situations, provide assistance to infection control and antibiotic stewardship programs, and potentially improve patient outcomes.

关 键 词：Carbapenem Non-Susceptible Check-MDR CT103 XL Microarray β-Lactamase Detection Resistance Mechanisms Ceftazidime-Avibactam 

分 类 号：R44[医药卫生—诊断学]