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Evaluation of the in vitro efficacy of non-beta-lactam antibiotics in extended-spectrum beta-lactamase-producing and non-producing Klebsiella spp. and Escherichia coli strains

Year 2021, , 47 - 53, 05.06.2021
https://doi.org/10.47582/jompac.900146

Abstract

Objective: Bacteria develop resistance to many antibiotics by using different mechanisms. The resistance of bacteria secreting extended-spectrum beta-lactamases to many antibiotics limits our treatment options. In this study, we investigated the in vitro efficacies of non-beta-lactam antibiotics in Escherichia coli (E. coli) and Klebsiella spp. strains.
Material and Method: In our study, we investigated the presence of ESBL in 97 ESBL-negative (61 E. coli, 36 Klebsiella spp.) and 54 ESBL-positive (33 E. coli, 21 Klebsiella spp.) strains of nosocomial origin isolated from blood culture through a phenotypic confirmation test. We determined in vitro efficacies of aminoglycoside and quinolone group antibiotics by the agar dilution method.
Results: The susceptibility rates of ESBL-producing and non-producing strains were 81.4% -48.1% to ciprofloxacin, 85.5%-50% to levofloxacin, 81.4%-46.3% to ofloxacin and moxifloxacin, 99%-37% to gentamicin, 97.9%-57.4% to netilmicin, and 99%-96.2% to amikacin, respectively.
Conclusion: In our study, we found that all aminoglycoside and quinolone group antibiotics showed low efficacies.Amikacin had the highest in vitro activity in E. coli and Klebsiellaspp. strains.

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References

  • Bush K, Bradford PA. Epidemiology of β-Lactamase-Producing Pathogens. Clin Microbiol Rev. 2020; 33: e00047-19
  • Bonomo RA. β-Lactamases: A focus on current challenges. Cold Spring Harb Perspect Med 2017; 7: a025239.
  • Bush K. Past and Present Perspectives on β-Lactamases. Antimicrob Agents Chemother 2018; 62: e01076-18.
  • Tooke CL, Hinchliffe P, Bragginton EC, et al. β-Lactamases and β-Lactamase Inhibitors in the 21st Century. J Mol Biol 2019; 431: 3472–500.
  • Bauvois C, Wouters J. Crystal structures of class C β-lactamases: Mechanistic implications and perspectives in drug design. In Enzyme-mediated resistance to antibiotics: Mechanisms, dissemination, and prospects for inhibition (ed. Bonomo RA, Tolmasky ME), ASM, Washington DC, 2007, pp:145–161.
  • Institute/NCCLS CaLS. Performance Standarts for Antimicrobial Susceptibility Testing; Fifteenth Informational Supplement. CLSI/NCCLS document. Clinical and Laboratory Standarts Institute, Wayne, Pennsylvania, 2005, pp:19087-1898.
  • Bush K. Bench-to-bedside review: The role of β-lactamases in antibiotic-resistant Gram negative infections. Crit Care 2010; 14: 224.
  • Bush K, Jacoby GA. Updated functional classification of β-lactamases. Antimicrob Agents Chemother 2010; 54: 969–76.
  • Sturenburg E, Mack D. Extended-spectrum beta-lactamases: implications for the clinical microbiology laboratory, therapy, and infection control. J Infect 2003; 47: 273-95.
  • Paterson DL, Bonomo RA. Extended-spectrum β-lactamases: A clinical update. Clin Microbiol Rev 2005; 18: 657–86.
  • Abdelaziz MO, Bonura C, Aleo A, et al. OXA-163-producing Klebsiellapneumoniae in Cairo, Egypt, in 2009 and 2010. J Clin Microbiol 2012; 50: 2489-91.
  • Lu S, Soeung V, Nguyen HAT, et al. Development and Evaluation of a Novel Protein-Based Assay for Specific Detection of KPC β-Lactamases from Klebsiella pneumoniae. mSphere. 2020; 5: e00918-19.
  • Juan C, Torrens G, Barceló IM, et al. Interplay between peptidoglycan biology and virulence in gram-negative pathogens. Microbiol Mol Biol Rev 2018; 82: e00033-18.
  • Nijssen S, Florijn A, Bonten MJ, et al. Beta-lactam susceptibilities and prevalence of ESBL-producing isolates among more than 5000 European Enterobacteriaceae isolates. Int J Antimicrob Agents 2004; 24: 585-91.
  • Gülay Z. Gram-negatif çomaklarda antibiyotik direnci. Ankem Derg 2005; 19: 66-77.
  • Jones RN, Pfaller MA; MYSTIC Study Group (Europe). Antimicrobial activity against strains of Escherichia coli and Klebsiella spp. with resistance phenotypes consistent with an extended-spectrum beta-lactamase in Europe. Clin Microbiol Infect 2003; 9: 708-12.
  • Jiang W, Yang W, Zhao X, et al. Klebsiella pneumoniae presents antimicrobial drug resistance for β-lactam through the ESBL/PBP signaling pathway. Exp Ther Med 2020; 19: 2449–56.
  • Fouhy F, Motherway MO, Fitzgerald GF, et al. In silico assigned resistance genes confer bifidobacterium with partial resistance to aminoglycosides but Not to Β-Lactams. PLoS One 2013; 8: e82653.
  • Mumcuoğlu İG, Baydur T. Escherichiae, Klebsiella ve Proteus suşlarında genişlemiş spektrumlu beta-laktamaz varlığı ve çeşitli antibiyotiklere direnç durumu. Ankem Derg 2004; 18: 9.
  • Paterson DL, Ko WC, Von Gottberg A, et al. Outcome of cephalosporin treatment for serious infections due to apparently susceptible organisms producing extended-spectrum beta-lactamases: implications for the clinical microbiology laboratory. J Clin Microbiol 2001; 39: 2206-12.
  • Wong-Beringer A. Therapeutic challenges associated with extended-spectrum, beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Pharmacotherapy 2001; 21: 583-92.
  • Heng ST, Chen SL, Wong JGX, et al. No association between resistance mutations, empiric antibiotic, and mortality in ceftriaxone-resistant Escherichia coli and Klebsiella pneumoniae bacteremia. Sci Rep 2018; 8: 12785.
  • RamphalR, Amnbrose PG. Extended-spectrum beta-lactamases and clinical outcomes: current data. Clin Infect Dis 2006; 42: 164-72.
  • Lautenbach E, Strom BL, Bilker WB, et al. Epidemiological investigation of fluoroquinolone resistance in infections due to extended-spectrum beta-lactamase-producing Escherichiacoli and Klebsiellapneumoniae. Clin Infect Dis 2001; 33: 1288-94.
  • Patterson JE. Antibiotic utilization: is there an effect on antimicrobial resistance? Chest 2001; 119: 426-30.
  • Paterson DL. Recommendation for treatment of severe infections caused by Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBLs). Clin Microbiol Infect 2000; 6: 460-3.
  • Essack SY. Treatment options for extended-spectrum beta-lactamase-producers. FEMS Microbiol Lett 2000; 190: 181-4.
  • Winokur RC, Caselles JM, and Legakis N. Variations in the prevalence of strains expressing an extended-spectrum beta-lactamase phenotype and characterization of isolates from Europe, the Americas, and the Western Pacific region. Clin Infect Dis 2001; 32: 94-103.
  • Ambrose RR. Extended-spectrum beta-lactamases and clinical outcomes: current data. Clin Infect Dis 2006; 42.
  • Leblebicioglu H, Gunaydin M, Esen S, et al. Surveillance of antimicrobial resistance in Gram-negative isolates from intensive care units in Turkey: analysis of data from the last 5 years. J Chemother 2002; 14: 140-6.
  • Yu Y, Zhou W, Chen Y, et al. Epidemiological and antibiotic resistant study on extended-spectrum beta-lactamase-producing Escherichiacoli and Klebsiellapneumoniae in Zhejiang Province. Chin Med J (Engl) 2002; 115: 1479-82.
  • Şahin İK, Öksüz D, Okay Ş, et al. Klinik örneklerden izole edilen Gram-negatif çomaklarda genişlemiş spektrumlu beta-laktamaz sıklığı ve antibiyotik duyarlılığı. İnffeksiyon Derg 2003; 17: 45-8.
  • Özbilge HY, İnanç F. Gram-negatif çomaklarda genişlemiş spektrumlu beta-laktamaz varlığı ve çeşitli antibiyotiklere direnç durumu. Ankem Derg 2003; 17: 13-5.
  • Zer YB, Orhan A, Çeliksöz G, Korkmaz C, et al. Hastanede yatan hastalarda izole edilen gram negative çomaklarda genişlemiş spektrumlu beta-laktamazların ve çeşitli antibiyotiklere duyarlılığın araştırılması. Anadolu Tıp Derg 2002; 4: 71-5.
  • Jones RN, Pfaller MA. Antimicrobial activity against strains of Escherichia coli and Klebsiella spp. with resistance phenotypes consistent with an extended-spectrum beta-lactamase in Europe. Clin Microbiol Infect 2003; 9: 708-12.
  • Domenech-Sanchez A, Pascual A, Suarez AI, et al. Activity of nine antimicrobial agents against clinical isolates of Klebsiellapneumoniae producing extended-spectrum beta-lactamases and deficient or not in porins. J Antimicrob Chemother 2000; 46: 858-9.
  • Sekowska A JG, Keyszejko C, Wojda M, et al. Resistance of Klebsiella pneumoniae strains producing and not producing ESBL (extended-spectrum beta-lactamase) type enzymes to selected non-beta-lactam antibiotics. Med Sci Monit 2002; 8: 100-4.
  • Babini GS, Livermore DM. Antimicrobial resistance amongst Klebsiella spp. collected from intensive care units in Southern and Western Europe in 1997-1998. J Antimicrob Chemother 2000; 45: 183-9.
  • Kizirgil A, Demirdag K, Ozden M, et al. In vitro activity of three different antimicrobial agents against ESBL producing Escherichia coli and Klebsiella pneumoniae blood isolates. Microbiol Res 2005; 160: 135-40.
  • Rice LB. Evolution and clinical importance of extented spectrum beta lactamases. Chest 2001; 119: 391-6.
  • Kınıklı S, Cesur S, Yücel M, Ataman Hatipoğlu Ç, Dinç B. Determination of polymyxin B, minocycline, colistin and phosphomycin susceptibilities in Acinetobacter baumannii strains showing carbapenem resistant multidrug resistance phenotype. J Health Sci Med 2019; 2: 49-53.
  • Savcı Ü, Şahin M, Toprak S, Sungur M. Antimicrobial resistance pattern of Streptococcus agalactiae strains: five years evaluation of single center. J Health Sci Med 2018; 1: 25-8.

Genişlemiş spektrumlu beta-laktamaz üreten ve üretmeyen Klebsiella spp. ve Escherichia coli suşlarında beta-laktam dışı antibiyotiklerin in vitro etkinliğinin değerlendirilmesi

Year 2021, , 47 - 53, 05.06.2021
https://doi.org/10.47582/jompac.900146

Abstract

Amaç: Bakteriler birçok antibiyotiklere farklı mekanizmaları kullanarak direnç geliştirmektedir. Genişlemiş spektrumlu beta-laktamaz (GSBL)-üreten bakterilerin pek çok antibiyotiğe karşı dirençli olmaları tedavi seçeneklerimizi kısıtlamaktadır. Bu çalışmada in vitro olarakEscherichia coli (E. coli) ve Klebsiellaspp.suşlarında beta-laktamdışıantibiyotiklerinetkinliğiniaraştırdık.
GereçveYöntem:Çalışmamızdakankültüründenizoleedilennozokomiyalkökenli97 GSBL-negatif (61E. coli, 36Klebsiellaspp.) ve 54 GSBL-pozitif (33E.coli, 21Klebsiellaspp.) suşunda GSBL varlığıfenotipikdoğrulamatestiilearaştırıldı. Aminoglikozidvekinolongrubuantibiyotiklerin in vitro etkinlikleri agar dilüsyonyöntemiilebelirlendi.
Bulgular:GSBL-üretenveüretmeyensuşlarınduyarlılıkoranlarısırasıylasiprofloksasiniçin %81,4-48,1;levofloksasiniçin %85,5-50;ofloksasinvemoksifloksasiniçin %81,4-46,3;gentamisiniçin %99-37;netilmisiniçin %97,9-57,4 veamikasiniçinde %99-96,2 olarakbulundu.
Sonuç: Çalışılmamızda E. coliveKlebsiellasppsuşlarındatümaminoglikozidvekinolongrubuantibiyotiklerinetkinliğinindüşükolduğu;amikasininenyüksek in vitro etkinliğe sahip olduğu görüldü

Project Number

-

References

  • Bush K, Bradford PA. Epidemiology of β-Lactamase-Producing Pathogens. Clin Microbiol Rev. 2020; 33: e00047-19
  • Bonomo RA. β-Lactamases: A focus on current challenges. Cold Spring Harb Perspect Med 2017; 7: a025239.
  • Bush K. Past and Present Perspectives on β-Lactamases. Antimicrob Agents Chemother 2018; 62: e01076-18.
  • Tooke CL, Hinchliffe P, Bragginton EC, et al. β-Lactamases and β-Lactamase Inhibitors in the 21st Century. J Mol Biol 2019; 431: 3472–500.
  • Bauvois C, Wouters J. Crystal structures of class C β-lactamases: Mechanistic implications and perspectives in drug design. In Enzyme-mediated resistance to antibiotics: Mechanisms, dissemination, and prospects for inhibition (ed. Bonomo RA, Tolmasky ME), ASM, Washington DC, 2007, pp:145–161.
  • Institute/NCCLS CaLS. Performance Standarts for Antimicrobial Susceptibility Testing; Fifteenth Informational Supplement. CLSI/NCCLS document. Clinical and Laboratory Standarts Institute, Wayne, Pennsylvania, 2005, pp:19087-1898.
  • Bush K. Bench-to-bedside review: The role of β-lactamases in antibiotic-resistant Gram negative infections. Crit Care 2010; 14: 224.
  • Bush K, Jacoby GA. Updated functional classification of β-lactamases. Antimicrob Agents Chemother 2010; 54: 969–76.
  • Sturenburg E, Mack D. Extended-spectrum beta-lactamases: implications for the clinical microbiology laboratory, therapy, and infection control. J Infect 2003; 47: 273-95.
  • Paterson DL, Bonomo RA. Extended-spectrum β-lactamases: A clinical update. Clin Microbiol Rev 2005; 18: 657–86.
  • Abdelaziz MO, Bonura C, Aleo A, et al. OXA-163-producing Klebsiellapneumoniae in Cairo, Egypt, in 2009 and 2010. J Clin Microbiol 2012; 50: 2489-91.
  • Lu S, Soeung V, Nguyen HAT, et al. Development and Evaluation of a Novel Protein-Based Assay for Specific Detection of KPC β-Lactamases from Klebsiella pneumoniae. mSphere. 2020; 5: e00918-19.
  • Juan C, Torrens G, Barceló IM, et al. Interplay between peptidoglycan biology and virulence in gram-negative pathogens. Microbiol Mol Biol Rev 2018; 82: e00033-18.
  • Nijssen S, Florijn A, Bonten MJ, et al. Beta-lactam susceptibilities and prevalence of ESBL-producing isolates among more than 5000 European Enterobacteriaceae isolates. Int J Antimicrob Agents 2004; 24: 585-91.
  • Gülay Z. Gram-negatif çomaklarda antibiyotik direnci. Ankem Derg 2005; 19: 66-77.
  • Jones RN, Pfaller MA; MYSTIC Study Group (Europe). Antimicrobial activity against strains of Escherichia coli and Klebsiella spp. with resistance phenotypes consistent with an extended-spectrum beta-lactamase in Europe. Clin Microbiol Infect 2003; 9: 708-12.
  • Jiang W, Yang W, Zhao X, et al. Klebsiella pneumoniae presents antimicrobial drug resistance for β-lactam through the ESBL/PBP signaling pathway. Exp Ther Med 2020; 19: 2449–56.
  • Fouhy F, Motherway MO, Fitzgerald GF, et al. In silico assigned resistance genes confer bifidobacterium with partial resistance to aminoglycosides but Not to Β-Lactams. PLoS One 2013; 8: e82653.
  • Mumcuoğlu İG, Baydur T. Escherichiae, Klebsiella ve Proteus suşlarında genişlemiş spektrumlu beta-laktamaz varlığı ve çeşitli antibiyotiklere direnç durumu. Ankem Derg 2004; 18: 9.
  • Paterson DL, Ko WC, Von Gottberg A, et al. Outcome of cephalosporin treatment for serious infections due to apparently susceptible organisms producing extended-spectrum beta-lactamases: implications for the clinical microbiology laboratory. J Clin Microbiol 2001; 39: 2206-12.
  • Wong-Beringer A. Therapeutic challenges associated with extended-spectrum, beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Pharmacotherapy 2001; 21: 583-92.
  • Heng ST, Chen SL, Wong JGX, et al. No association between resistance mutations, empiric antibiotic, and mortality in ceftriaxone-resistant Escherichia coli and Klebsiella pneumoniae bacteremia. Sci Rep 2018; 8: 12785.
  • RamphalR, Amnbrose PG. Extended-spectrum beta-lactamases and clinical outcomes: current data. Clin Infect Dis 2006; 42: 164-72.
  • Lautenbach E, Strom BL, Bilker WB, et al. Epidemiological investigation of fluoroquinolone resistance in infections due to extended-spectrum beta-lactamase-producing Escherichiacoli and Klebsiellapneumoniae. Clin Infect Dis 2001; 33: 1288-94.
  • Patterson JE. Antibiotic utilization: is there an effect on antimicrobial resistance? Chest 2001; 119: 426-30.
  • Paterson DL. Recommendation for treatment of severe infections caused by Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBLs). Clin Microbiol Infect 2000; 6: 460-3.
  • Essack SY. Treatment options for extended-spectrum beta-lactamase-producers. FEMS Microbiol Lett 2000; 190: 181-4.
  • Winokur RC, Caselles JM, and Legakis N. Variations in the prevalence of strains expressing an extended-spectrum beta-lactamase phenotype and characterization of isolates from Europe, the Americas, and the Western Pacific region. Clin Infect Dis 2001; 32: 94-103.
  • Ambrose RR. Extended-spectrum beta-lactamases and clinical outcomes: current data. Clin Infect Dis 2006; 42.
  • Leblebicioglu H, Gunaydin M, Esen S, et al. Surveillance of antimicrobial resistance in Gram-negative isolates from intensive care units in Turkey: analysis of data from the last 5 years. J Chemother 2002; 14: 140-6.
  • Yu Y, Zhou W, Chen Y, et al. Epidemiological and antibiotic resistant study on extended-spectrum beta-lactamase-producing Escherichiacoli and Klebsiellapneumoniae in Zhejiang Province. Chin Med J (Engl) 2002; 115: 1479-82.
  • Şahin İK, Öksüz D, Okay Ş, et al. Klinik örneklerden izole edilen Gram-negatif çomaklarda genişlemiş spektrumlu beta-laktamaz sıklığı ve antibiyotik duyarlılığı. İnffeksiyon Derg 2003; 17: 45-8.
  • Özbilge HY, İnanç F. Gram-negatif çomaklarda genişlemiş spektrumlu beta-laktamaz varlığı ve çeşitli antibiyotiklere direnç durumu. Ankem Derg 2003; 17: 13-5.
  • Zer YB, Orhan A, Çeliksöz G, Korkmaz C, et al. Hastanede yatan hastalarda izole edilen gram negative çomaklarda genişlemiş spektrumlu beta-laktamazların ve çeşitli antibiyotiklere duyarlılığın araştırılması. Anadolu Tıp Derg 2002; 4: 71-5.
  • Jones RN, Pfaller MA. Antimicrobial activity against strains of Escherichia coli and Klebsiella spp. with resistance phenotypes consistent with an extended-spectrum beta-lactamase in Europe. Clin Microbiol Infect 2003; 9: 708-12.
  • Domenech-Sanchez A, Pascual A, Suarez AI, et al. Activity of nine antimicrobial agents against clinical isolates of Klebsiellapneumoniae producing extended-spectrum beta-lactamases and deficient or not in porins. J Antimicrob Chemother 2000; 46: 858-9.
  • Sekowska A JG, Keyszejko C, Wojda M, et al. Resistance of Klebsiella pneumoniae strains producing and not producing ESBL (extended-spectrum beta-lactamase) type enzymes to selected non-beta-lactam antibiotics. Med Sci Monit 2002; 8: 100-4.
  • Babini GS, Livermore DM. Antimicrobial resistance amongst Klebsiella spp. collected from intensive care units in Southern and Western Europe in 1997-1998. J Antimicrob Chemother 2000; 45: 183-9.
  • Kizirgil A, Demirdag K, Ozden M, et al. In vitro activity of three different antimicrobial agents against ESBL producing Escherichia coli and Klebsiella pneumoniae blood isolates. Microbiol Res 2005; 160: 135-40.
  • Rice LB. Evolution and clinical importance of extented spectrum beta lactamases. Chest 2001; 119: 391-6.
  • Kınıklı S, Cesur S, Yücel M, Ataman Hatipoğlu Ç, Dinç B. Determination of polymyxin B, minocycline, colistin and phosphomycin susceptibilities in Acinetobacter baumannii strains showing carbapenem resistant multidrug resistance phenotype. J Health Sci Med 2019; 2: 49-53.
  • Savcı Ü, Şahin M, Toprak S, Sungur M. Antimicrobial resistance pattern of Streptococcus agalactiae strains: five years evaluation of single center. J Health Sci Med 2018; 1: 25-8.
There are 42 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Göknur Yapar Toros

Funda Timurkaynak 0000-0002-1940-9186

Project Number -
Publication Date June 5, 2021
Published in Issue Year 2021

Cite

AMA Yapar Toros G, Timurkaynak F. Evaluation of the in vitro efficacy of non-beta-lactam antibiotics in extended-spectrum beta-lactamase-producing and non-producing Klebsiella spp. and Escherichia coli strains. J Med Palliat Care / JOMPAC / Jompac. June 2021;2(2):47-53. doi:10.47582/jompac.900146

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