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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">antibiotics</journal-id><journal-title-group><journal-title xml:lang="ru">Антибиотики и Химиотерапия</journal-title><trans-title-group xml:lang="en"><trans-title>Antibiot Khimioter = Antibiotics and Chemotherapy</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0235-2990</issn><publisher><publisher-name>ООО «Издательство ОКИ»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.37489/0235-2990-2024-69-11-12-32-40</article-id><article-id custom-type="edn" pub-id-type="custom">MOTBYZ</article-id><article-id custom-type="elpub" pub-id-type="custom">antibiotics-1203</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ЭКСПЕРИМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>EXPERIMENTAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Эффективность комбинации меропенем/авибактам при действии на карбапенемазопродуцирующие штаммы Klebsiella pneumoniae в динамической системе in vitro</article-title><trans-title-group xml:lang="en"><trans-title>The Effectiveness of the Combined Use of Meropenem and Avibactam Against Carbapenemase-Producing Klebsiella pneumoniae Strains in an in vitro Dynamic Model</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5391-1137</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Струкова</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Strukova</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Струкова Елена Николаевна — к. б. н., старший научный сотрудник лаборатории фармакокинетики и фармакодинамики. ResearcherID: C-9446-2015. Scopus Author ID: 24336721100. eLibrary SPIN-код: 9693-7240</p><p>Москва</p></bio><bio xml:lang="en"><p>Elena N. Strukova — Ph. D. in Biology, Senior Researcher at the Laboratory of Pharmacokinetics and Pharmacodynamics, Gause Institute of New Antibiotics (GINA), ResearcherID: C-9446-2015. Scopus Author ID: 24336721100. eLibrary SPINcode: 9693-7240.</p><p>Moscow</p></bio><email xlink:type="simple">kindyn@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7588-1733</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Голикова</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Golikova</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Голикова Мария Владимировна — к. б. н., зав. лабораторией фармакокинетики и фармакодинамики. Researcher ID: O-7873-2016. eLibrary SPIN-код: 9078-4922. Scopus Author ID: 56497807500.</p><p>Москва</p></bio><bio xml:lang="en"><p>Maria V. Golikova — Ph. D. in Biology, Head of Laboratory of Pharmacokinetics and Pharmacodynamics, Gause Institute of New Antibiotics (GINA), Researcher ID: O-7873-2016. eLibrary SPIN-code: 9078-4922. Scopus Author ID: 56497807500.</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2917-9249</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кобрин</surname><given-names>М. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Kobrin</surname><given-names>M. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кобрин Михаил Борисович — старший научный сотрудник лаборатории фармакокинетики и фармакодинамики. Scopus Author ID: 7003801263.</p><p>Москва</p></bio><bio xml:lang="en"><p>Mikhail B. Kobrin — Senior Researcher at the Laboratory of Pharmacokinetics and Pharmacodynamics, Russia. Scopus Author ID: 7003801263.</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7045-7917</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Довженко</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Dovzhenko</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Довженко Светлана Анатольевна — к. х. н., старший научный сотрудник лаборатории фармакокинетики и фармакодинамики. Scopus Author ID: 6602290196.</p><p>Москва</p></bio><bio xml:lang="en"><p>Svetlana A. Dovzhenko — Ph. D. in Chemistry, Senior Researcher, Laboratory of Pharmacokinetics and Pharmacodynamics, Gause Institute of New Antibiotics (GINA), Scopus Author ID: 6602290196.</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3645-1933</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Голышкин</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Golyshkin</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Голышкин Александр Владимирович — младший научный сотрудник лаборатории биосинтеза биологически активных веществ. Scopus Author ID: 56406498400.</p><p>Москва</p></bio><bio xml:lang="en"><p>Alexandr V. Golyshkin — Junior Researcher at the Laboratory of Biosynthesis of Biologically Active Substances. Scopus Author ID: 56406498400.</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9575-1701</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Альмяшева</surname><given-names>Н. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Almyasheva</surname><given-names>N. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Альмяшева Наиля Рафиковна — младший научный сотрудник лаборатории биосинтеза биологически активных веществ,  Scopus Author ID: 56406547700.</p><p>Москва</p></bio><bio xml:lang="en"><p>Nailya R. Almyasheva — Junior Researcher at the Laboratory of Biosynthesis of Biologically Active Substances, Scopus Author ID: 56406547700.</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9588-7876</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Портной</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Portnoy</surname><given-names>Yu. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Портной Юрий Абрамович — старший научный сотрудник лаборатории фармакокинетики и фармакодинамики, Scopus Author ID: 6602151494.</p><p>Москва</p></bio><bio xml:lang="en"><p>Yury A. Portnoy — Senior Researcher at the Laboratory of Pharmacokinetics and Pharmacodynamics, Scopus Author ID: 6602151494.</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт по изысканию новых антибиотиков им. Г.Ф. Гаузе» (ФГБНУ «НИИНА»)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Gause Institute of New Antibiotics (GINA)</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>25</day><month>12</month><year>2024</year></pub-date><volume>69</volume><issue>11-12</issue><fpage>32</fpage><lpage>40</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Струкова Е.Н., Голикова М.В., Кобрин М.Б., Довженко С.А., Голышкин А.В., Альмяшева Н.Р., Портной Ю.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Струкова Е.Н., Голикова М.В., Кобрин М.Б., Довженко С.А., Голышкин А.В., Альмяшева Н.Р., Портной Ю.А.</copyright-holder><copyright-holder xml:lang="en">Strukova E.N., Golikova M.V., Kobrin M.B., Dovzhenko S.A., Golyshkin A.V., Almyasheva N.R., Portnoy Y.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.antibiotics-chemotherapy.ru/jour/article/view/1203">https://www.antibiotics-chemotherapy.ru/jour/article/view/1203</self-uri><abstract><sec><title>Актуальность</title><p>Актуальность. Для борьбы с инфекциями, вызванными карбапенемазопродуцирующими штаммами K. pneumoniae, успешно применяются комбинации карбапенемов с ингибиторами карбапенемаз нового поколения. Однако в клинике известны случаи устойчивости K. pneumoniae и к таким комбинациям. В этой связи важно продолжать поиск и изучение новых сочетаний антибиотик/ингибитор. В этом смысле интересна комбинация меропенем/авибактам, изучению эффективности которой посвящено данное исследование.</p></sec><sec><title>Цель</title><p>Цель. Оценить эффективность комбинации меропенема с новым ингибитором карбапенемаз авибактамом при действии на штаммы K. pneumoniae, продуцирующие карбапенемазы, в динамической системе in vitro.</p></sec><sec><title>Методы</title><p>Методы. Два штамма-продуцента карбапенемаз, типа KPC (K. pneumoniae 28) и OXA-48 (K. pneumoniae 145), подвергали воздействию меропенема или его комбинации с авибактамом в динамической системе in vitro, где моделировали фармакокинетические профили препаратов в эпителиальной жидкости лёгких человека. Воспроизводили следующие режимы дозирования: 2000 мг меропенема и 500 мг авибактама в виде 2-часовой инфузии каждые 8 ч 5 дней. Оценивали эффект препаратов в отношении общей и устойчивых субпопуляций K. pneumoniae путём высева проб на агаризованные среды без меропенема и с ним в концентрациях, кратных минимальной подавляющей концентрации.</p></sec><sec><title>Результаты</title><p>Результаты. Меропенем не снижал численность общей популяции и не подавлял рост резистентных субпопуляций обоих штаммов, в то время как комбинирование меропенема с авибактамом заметно снижало общий бактериальный титр и полностью предотвращало рост устойчивых клеток.</p></sec><sec><title>Заключение</title><p>Заключение. Комбинация меропенем/авибактам представляется перспективной для применения в клинике, поскольку характеризовалась высокой эффективностью и отсутствием развития резистентности к меропенему на протяжении всего моделируемого курса терапии.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Background</title><p>Background. Combinations of carbapenems with new-generation carbapenemase inhibitors are successfully used to combat infections caused by carbapenemase-producing Klebsiella pneumoniae strains. However, K. pneumoniae resistance to such combinations is already described. Therefore, the search for new antibiotic/inhibitor combinations is important. In this regard, meropenem/avibactam combination seems promising, with its effectiveness becoming the subject of the current study.</p><p>The aim of this study was to evaluate the effectiveness of the combination of meropenem with the new carbapenemase inhibitor avibactam against carbapenemase-producing K. pneumoniae strains in an in vitro dynamic model.</p></sec><sec><title>Methods</title><p>Methods. Two carbapenemase-producing strains, KPC (K. pneumoniae 28) and OXA-48 (K. pneumoniae 145), were exposed to meropenem or its combination with avibactam in the hollow fiber infection model that simulated the pharmacokinetic profiles of drugs in the human lung epithelial fluid. The following dosage regimens were simulated: 2000 mg of meropenem and 500 mg of avibactam as a 2-hour infusion every 8 hours during 5 days. The effect of the drugs on the total and resistant subpopulations of K. pneumoniae was evaluated by plating samples on agar media without and with meropenem at different MIC-fold concentrations.</p></sec><sec><title>Results</title><p>Results. Meropenem alone did not reduce the numbers of the total population and did not suppress the growth of resistant subpopulations of both strains, while combining meropenem with avibactam significantly reduced the total bacterial numbers and completely prevented the growth of resistant cells.</p></sec><sec><title>Conclusion</title><p>Conclusion. The combination of meropenem/avibactam seems promising, due to the fact that it was characterized by high eﬃcacy and a lack of development of resistance to meropenem throughout the entire simulated course of therapy.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>меропенем</kwd><kwd>авибактам</kwd><kwd>K. pneumoniae</kwd><kwd>динамическая система in vitro</kwd><kwd>фармакокинетика</kwd><kwd>фармакодинамика</kwd></kwd-group><kwd-group xml:lang="en"><kwd>meropenem</kwd><kwd>avibactam</kwd><kwd>K. pneumoniae</kwd><kwd>hollow fiber infection model</kwd><kwd>pharmacokinetics</kwd><kwd>pharmacodynamics</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование проведено благодаря финансовой поддержке Российского научного фонда (грант РНФ, соглашение № 23-25-00524 от 13.01.2023 г.)</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Яковлев С. 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