1. In Vitro Efficacy of Six Alternative Antibiotics against Multidrug Resistant Escherichia Coli and Klebsiella Pneumoniae from Urinary Tract Infections.
- Author
-
Chen YT, Ahmad Murad K, Ng LS, Seah JT, Park JJ, and Tan TY
- Subjects
- Amdinocillin pharmacology, Bacterial Proteins genetics, Ceftibuten, Ceftizoxime analogs & derivatives, Ceftizoxime pharmacology, Cephalosporins pharmacology, Drug Resistance, Multiple, Bacterial genetics, Escherichia coli genetics, Escherichia coli Infections microbiology, Fosfomycin pharmacology, Genotype, Humans, In Vitro Techniques, Klebsiella Infections microbiology, Klebsiella pneumoniae genetics, Microbial Sensitivity Tests, Multiplex Polymerase Chain Reaction, Penicillins pharmacology, Singapore, Trimethoprim pharmacology, beta-Lactamases genetics, Cefpodoxime, Anti-Bacterial Agents pharmacology, Escherichia coli drug effects, Klebsiella pneumoniae drug effects, Urinary Tract Infections microbiology
- Abstract
Introduction: Increasing resistance in Escherichia coli and Klebsiella pneumoniae to firstline antibiotics makes therapeutic options for urinary tract infections (UTIs) challenging. This study investigated the in vitro efficacies of 6 antibiotics against multidrug resistant (MDR) uropathogens., Materials and Methods: Minimum inhibitory concentrations to ceftibuten, cefpodoxime, fosfomycin, mecillinam, temocillin, and trimethoprim were determined against 155 MDR-isolates of E. coli and K. pneumoniae. The presence of extended-spectrum beta-lactamases (ESBL) and plasmid-borne AmpC enzymes was determined by phenotypic testing with genotyping performed by multiplex polymerase chain reaction., Results: Temocillin demonstrated highest susceptibility rates for both E. coli (95%) and K. pneumoniae (95%) when breakpoints for uncomplicated UTIs were applied; however, temocillin susceptibility was substantially lower when "systemic infection" breakpoints were used. Fosfomycin demonstrated the best in vitro efficacy of the orally available agents, with 78% and 69% of E. coli and K. pneumoniae isolates susceptible, respectively. The next most effective antibiotics were ceftibuten (45%) and mecillinam (32%). ESBL and ampC genes were present in 47 (30%) and 59 (38%) isolates., Conclusion: This study demonstrated few oral therapeutic options for MDR-uropathogens, with fosfomycin demonstrating the best in vitro activity.
- Published
- 2016