Distribution of values of indicators of minimum suppressive concentrations of antibiotics in relation to gram-negative bacterial strains isolated from cystic fibrosis

Abstract

Introduction. Cystic fibrosis is a severe chronic genetic disease, in which the microbiological status of the patient plays an important role, because it will determine the severity of the respiratory infection. In recent years, representatives of non-fermenting gram-negative bacteria (NFGNB) - P. aeruginosa, B. cenocepacia, Axylosoxidans; as well as representatives of the order Flavobacteriales - have become of great clinical importance in patients with cystic fibrosis. A feature of some representatives of NFGNB is the formation of resistance to antibacterial drugs, due to prolonged antimicrobial therapy. In addition to the acquired, there is a high level of natural resistance, and therefore the possibilities of using antibacterial drugs are significantly limited.Aim. To estimate the distribution of the values of the minimum suppressive concentrations (MSC) of cefepim / sulbactam, piperacillin / tazobactam, biapenem in relation to 100 strains of Gram-negative bacteria isolated from respiratory samples from patients with cystic fibrosis.Materials and methods. To date, new compounds have appeared with potential activity against the strains under consideration - cefepim / sulbactam, piperacillin / tazobactam, biapenem. We selected 100 bacterial strains isolated from respiratory samples from patients with cystic fibrosis from various regions of the Russian Federation. Among them, 69 strains are Pseudomonas aeruginosa, 6 - Achromobacter xylosoxidans, 14 - Burkholderia cenocepacia, 10 - Chryseobacterium spp., 1 - Elizabethkingia miricola. MSC values were determined for 3 antimicrobial drugs: cefepim / sulbactam, piperacillin / tazobactam, biapenem.Results and discussions. According to the data obtained, it was found that most strains of Pseudomonas aeruginosa, Achromobacter xylosoxidans have a high level of sensitivity to cefepim/sulbactam, piperacillin/tazobactam. The criteria for evaluating the MSC indicators of the studied drugs in relation to Burkholderia cenocepacia and representatives of the order Flavobacteriales have not been determined, however, it is worth noting that most isolates have demonstrated an achievable value of MSC indicators. This suggests the possibility of practical application of antimicrobial drugs under test.Conclusions. The data obtained indicate the microbiological efficacy of the drugs: cefepim/sulbactam, piperacillin/tazobactam, biapenem relative to NFGNB isolated from patients with cystic fibrosis.