In Vitro Efficacy of Six Alternative Antibiotics against Multidrug Resistant Escherichia Coli and Klebsiella Pneumoniae from Urinary Tract Infections
Annals of the Academy of Medicine, Singapore
;
: 245-250, 2016.
Article
in English
| WPRIM
| ID: wpr-353699
ABSTRACT
<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>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Penicillins
/
Pharmacology
/
Singapore
/
Bacterial Proteins
/
Trimethoprim
/
Urinary Tract Infections
/
Beta-Lactamases
/
In Vitro Techniques
/
Klebsiella Infections
/
Ceftizoxime
Limits:
Humans
Country/Region as subject:
Asia
Language:
English
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2016
Type:
Article
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