In Vitro Efficacy of Six Alternative Antibiotics against Multidrug Resistant Escherichia Coli and Klebsiella Pneumoniae from Urinary Tract Infections.
- Author:
Yu Ting CHEN
1
;
Katzrin Ahmad MURAD
;
Lily Sy NG
;
Jonathan Th SEAH
;
Joon Jae PARK
;
Thean Yen TAN
Author Information
- Publication Type:Journal Article
- MeSH: Amdinocillin; pharmacology; Anti-Bacterial Agents; pharmacology; Bacterial Proteins; genetics; Ceftizoxime; analogs & derivatives; pharmacology; Cephalosporins; pharmacology; Drug Resistance, Multiple, Bacterial; genetics; Escherichia coli; drug effects; genetics; Escherichia coli Infections; microbiology; Fosfomycin; pharmacology; Genotype; Humans; In Vitro Techniques; Klebsiella Infections; microbiology; Klebsiella pneumoniae; drug effects; genetics; Microbial Sensitivity Tests; Multiplex Polymerase Chain Reaction; Penicillins; pharmacology; Singapore; Trimethoprim; pharmacology; Urinary Tract Infections; microbiology; beta-Lactamases; genetics
- From:Annals of the Academy of Medicine, Singapore 2016;45(6):245-250
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONIncreasing 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 METHODSMinimum 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.
RESULTSTemocillin 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.
CONCLUSIONThis study demonstrated few oral therapeutic options for MDR-uropathogens, with fosfomycin demonstrating the best in vitro activity.
