In vitro activity of flomoxef and comparators against Escherichia coil, Klebsiella pneumoniae and Proteus mirabilis producing extended-spectrum beta-lactamases in China
单位：[a]Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1Shuaifuyuan, Wangfujing Street, Beijing 100730, China[b]Chaoyang Hospital of Capital Medical College, Beijing 100020, China北京朝阳医院[c]The First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China浙江大学医学院附属第一医院[d]Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China[e]Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China[f]Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China华中科技大学同济医学院附属同济医院[g]Zhongshan Hospital of Fu Dan University, Shanghai 200032, China[h]The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China重庆医科大学附属第一医院[i]Shandong Provincial Hospital, Jinan 250021, China[j]Xiangya Hospital, Central Southern University, Changsha 410008, China[k]The First Affiliated Hospital of Zhengzhou University, Zhenzhou 450052, China[l]The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China院本部中山大学附属第一医院[m]General Hospital of PLA, Beijing 100853, China[n]General Hospital of Tianjin Medical University, Tianjing 300052, China[o]The First Affiliated Hospital of Chinese Medical University, Shenyang 110001, China[p]The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China[q]Friendship Hospital of Capital Medical College, Beijing 100020, China首都医科大学附属北京友谊医院[r]The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China[s]People’s Hospital of Jilin Province, Jilin 130021, China[t]People’s Hospital of Haikou City, Haikou 570208, China[u]General Hospital of Nanjing Military Command, Nanjing 210002, China
The objective of this study was to better understand the in vitro activity of flomoxef against clinical extended-spectrum p-lactamase (ESBL)-producing Enterobacteriaceae. A total of 401 ESBL-producing isolates, including 196 Escherichia coli, 124 Klebsiella pneumoniae and 81 Proteus mirabilis, were collected consecutively from 21 hospitals in China in 2013. Minimum inhibitory concentrations (MICs) were determined by broth microdilution methods. Phenotypic identification of ESBL production was detected as recommended by the Clinical and Laboratory Standards Institute (CLSI). ESBL genes were detected by PCR and sequencing. Flomoxef, doripenem, meropenem, ertapenem, cefmetazole and piperacillin/tazobactam exhibited good activity against ESBL-producing isolates, with susceptibility rates >90%. Tigecycline showed good activity against E. coli and K. pneumoniae (100% and 97.6%, respectively). Cefotaxime and cefepime showed very low activities against ESBL-producing isolates, with susceptibility rates of 0-0.8% and 1.0-13.6%, respectively. bla(CTXM) were the major ESBL genes, with occurrence in 99.5% of E. coli, 91.1% of K. pneumoniae and 97.5% of P. mirabilis. bla(CTX-M-14) was the predominant ESBL gene, detected in 46.9% (188/401) of the isolates, followed by bla(CTX-M-15) (2 1.4%), bla(CTX-M-55) (1 7.2%), bla(CTX-M-65) (1 2.7%) and bla(CTX-M-3) (6.7%). Flomoxef exhibited excellent activity against the different CTX-M-type ESBL-producing isolates, with MIC50 and MIC90 values of 0.064-0.125 mu g/mL and 0.25-0.5 mu g/mL, respectively. Against the isolates solely producing CTX-M-14, -15, -55, -3 or -65, flomoxef showed susceptibility rates of 98.6%, 98.0%, 98.1%, 100.0% and 97.4%, respectively. In conclusion, flomoxef showed good activity against ESBL-producing Enterobacteriaceae and may be a choice to treat infections caused by these isolates in China. (C) 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
基金：
Shionogi Co., Ltd.; National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81101287]
第一作者单位：[a]Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1Shuaifuyuan, Wangfujing Street, Beijing 100730, China
通讯作者：
推荐引用方式(GB/T 7714)：
Qiwen Yang,Hui Zhang,Jingwei Cheng,et al.In vitro activity of flomoxef and comparators against Escherichia coil, Klebsiella pneumoniae and Proteus mirabilis producing extended-spectrum beta-lactamases in China[J].INTERNATIONAL JOURNAL of ANTIMICROBIAL AGENTS.2015,45(5):485-490.doi:10.1016/j.ijantimicag.2014.11.012.
APA：
Qiwen Yang,Hui Zhang,Jingwei Cheng,Zhipeng Xu,Yingchun Xu...&Haifeng Shao.(2015).In vitro activity of flomoxef and comparators against Escherichia coil, Klebsiella pneumoniae and Proteus mirabilis producing extended-spectrum beta-lactamases in China.INTERNATIONAL JOURNAL of ANTIMICROBIAL AGENTS,45,(5)
MLA：
Qiwen Yang,et al."In vitro activity of flomoxef and comparators against Escherichia coil, Klebsiella pneumoniae and Proteus mirabilis producing extended-spectrum beta-lactamases in China".INTERNATIONAL JOURNAL of ANTIMICROBIAL AGENTS 45..5(2015):485-490
