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Annals of the Academy of Medicine, Singapore ; : 245-250, 2016.
Artículo en Inglés | WPRIM | ID: wpr-353699

RESUMEN

<p><b>INTRODUCTION</b>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.</p><p><b>MATERIALS AND METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>This study demonstrated few oral therapeutic options for MDR-uropathogens, with fosfomycin demonstrating the best in vitro activity.</p>


Asunto(s)
Humanos , Amdinocilina , Farmacología , Antibacterianos , Farmacología , Proteínas Bacterianas , Genética , Ceftizoxima , Farmacología , Cefalosporinas , Farmacología , Farmacorresistencia Bacteriana Múltiple , Genética , Escherichia coli , Genética , Infecciones por Escherichia coli , Microbiología , Fosfomicina , Farmacología , Genotipo , Técnicas In Vitro , Infecciones por Klebsiella , Microbiología , Klebsiella pneumoniae , Genética , Pruebas de Sensibilidad Microbiana , Reacción en Cadena de la Polimerasa Multiplex , Penicilinas , Farmacología , Singapur , Trimetoprim , Farmacología , Infecciones Urinarias , Microbiología , beta-Lactamasas , Genética
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