Synergistic effects of ceftazidime/avibactam combined with meropenem in a murine model of infection with KPC-producing Klebsiella pneumoniae
文献类型： 外文期刊
作者： Zheng, Mei 1 ; Li, Fu-Hao 1 ; Liu, Juan 1 ; Li, Wen-Jie 1 ; Yin, Ruo-Xi 1 ; Cai, Da-Tong 1 ; Andrey, Diego O. 4 ; Zheng, Si-Lin 1 ; Gales, Ana C. 6 ; Zhang, Wan-Jiang 7 ; Sun, Jian 1 ; Liao, Xiao-Ping 1 ; Yu, Yang 1 ;
作者机构： 1.South China Agr Univ, State Key Lab Anim Dis Control & Prevent, Guangzhou, Peoples R China
2.South China Agr Univ, Guangdong Prov Key Lab Vet Pharmaceut Dev & Safety, Guangzhou, Peoples R China
3.South China Agr Univ, Coll Vet Med, Guangdong Lab Lingnan Modern Agr, Natl Risk Assessment Lab Antimicrobial Resistance, Guangzhou, Peoples R China
4.Geneva Univ Hosp, Serv Infect Dis, CH-1211 Geneva, Switzerland
5.Fac Med, CH-1211 Geneva, Switzerland
6.Univ Fed Sao Paulo, UNIFESP, Escola Paulista Med, Infect Dis Div, Sao Paulo, Brazil
7.Chinese Acad Agr Sci, Harbin Vet Res Inst, State Key Lab Vet Biotechnol, Harbin, Peoples R China
期刊名称：JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY （ 影响因子：5.2； 五年影响因子：5.4 ）
ISSN： 0305-7453
年卷期： 2024 年
页码：
收录情况： SCI
摘要： Objectives The emergence and expansion of carbapenem-resistant Klebsiella pneumoniae infections is a concern due to the lack of 'first-line' antibiotic treatment options. The ceftazidime/avibactam is an important clinical treatment for carbapenem-resistant K. pneumoniae infections but there is an increasing number of cases of treatment failure and drug resistance. Therefore, a potential solution is combination therapies that result in synergistic activity against K. pneumoniae carbapenemase: producing K. pneumoniae (KPC-Kp) isolates and preventing the emergence of KPC mutants resistant to ceftazidime/avibactam are needed in lieu of novel antibiotics.Methods To evaluate their synergistic activity, antibiotic combinations were tested against 26 KPC-Kp strains. Antibiotic resistance profiles, molecular characteristics and virulence genes were investigated by susceptibility testing and whole-genome sequencing. Antibiotic synergy was evaluated by in vitro chequerboard experiments, time-killing curves and dose-response assays. The mouse thigh model was used to confirm antibiotic combination activities in vivo. Additionally, antibiotic combinations were evaluated for their ability to prevent the emergence of ceftazidime/avibactam resistant mutations of blaKPC.Results The combination of ceftazidime/avibactam plus meropenem showed remarkable synergistic activity against 26 strains and restored susceptibility to both the partnering antibiotics. The significant therapeutic effect of ceftazidime/avibactam combined with meropenem was also confirmed in the mouse model and bacterial loads in the thigh muscle of the combination groups were significantly reduced. Furthermore, ceftazidime/avibactam plus meropenem showed significant activity in preventing the occurrence of resistance mutations.Conclusions Our results indicated that the combination of ceftazidime/avibactam plus meropenem offers viable therapeutic alternatives in treating serious infections due to KPC-Kp.
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