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In Vitro Efficacy of Six Alternative Antibiotics against Multidrug Resistant Escherichia Coli and Klebsiella Pneumoniae from Urinary Tract Infections.
- Source :
-
Annals of the Academy of Medicine, Singapore [Ann Acad Med Singap] 2016 Jun; Vol. 45 (6), pp. 245-50. - Publication Year :
- 2016
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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.<br />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.<br />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.<br />Conclusion: This study demonstrated few oral therapeutic options for MDR-uropathogens, with fosfomycin demonstrating the best in vitro activity.
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 2972-4066
- Volume :
- 45
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Annals of the Academy of Medicine, Singapore
- Publication Type :
- Academic Journal
- Accession number :
- 27412057