Piperacillin / Tazobactam in-vitro Activity in Escherichia coli and Klebsiella pneumoniae Strains with Extended Spectrum Beta-Lactamase Production

Year 2019, Volume: 4 Issue: 2, 118 - 127, 30.06.2019

Özlem Aydemir Hüseyin Agah Terzi Mehmet Köroğlu Mustafa Altındiş

https://doi.org/10.26453/otjhs.487008

Cited By: 3

Abstract

Piperacillin-tazobactam
(TZP) is a frequently preferred agent for the treatment of infections caused by
Gram-negative bacteria producing expanded spectrum beta-lactamase (ESBL).
However, there are some controversies about the efficacy of Piperacillin-tazobactam
in severe infections caused by ESBL producing bacteria. In this study, we aimed
to determine the efficacy of TZP in ESBL-positive bacteria isolated from the
samples sent to our laboratory. Our
medical microbiology laboratory included 548 ESBL producing Escherichia coli and Klebsiella pneumoniae strains from
blood, urine, wounds, tracheal aspirate samples from outpatient and outpatient
clinics. VITEC 2® was used for bacterial identification, antibiotic
susceptibility study and ESBL detection. Our study included 307 (56%) E. coli, 241 (%43.9) K. pneumoniae isolates. When the
resistance rates of TZP of isolates are examined; The resistance rate of TZP in
E. coli strains was 44.6% and the
highest resistance was detected in tracheal aspirates with 47.6%.  In K.
peumoniae strains, the resistance rate of TZP was found to be 41%. While
there are not enough studies showing the efficacy of TZP in infections caused
by ESBL positive bacteria, the existing studies show that the efficacy of these
antibiotics changes according to infection site and severity. There is no
consensus between CLSI and EUCAST regarding the TZP result notification.
Therefore, there is a need for more extensive work in this regard and a
reevaluation of the outcome report of the TZP.

Genişlemiş Spektrumlu Beta-laktamaz Üreten Escherichia coli ve Klebsiella pneumoniae Suşlarında Piperasilin/Tazobaktam İnvitro Etkinliği

Abstract

Piperasilin-tazobaktam
(TZP), genişletilmiş spektrumlu beta-laktamaz (GSBL) üreten Gram-negatif
bakterilerin  neden olduğu
enfeksiyonların tedavisi için sıklıkla tercih edilen bir ajandır. Bununla
birlikte, GSBL üreten bakterilerin neden olduğu ciddi enfeksiyonlara
Piperasilin-tazobaktamın etkinliği hakkında tartışmalar vardır. Bu çalışmada,
laboratuvara gönderilen örneklerden izole edilen GSBL pozitif bakterilerde
TZP'nin etkinliğini belirlemeyi amaçladık.
Servis ve poliklinik hastalarına ait kan, idrar, yara, trakeal aspirat
örneklerinden izole edilen 548 GSBL pozitif Escherichia
coli ve Klebsiella pneumoniae
suşu çalışmaya dahil edildi. Bakteri tanımlaması, antibiyotik duyarlılık
testleri ve GSBL tespitinde VİTEK 2® otomatize sistemi kullanıldı.
Çalışmamıza dahil edilen izolatların 307’si (%56) E. coli, 241’i (%43,9) K.
pneumoniae suşu idi. İzolatların TZP direnç oranları incelendiğinde; E. coli suşlarında TZP direnç oranı
%44,6 olarak saptanırken en yüksek direnç %47,6 ile trakeal aspirat
örneklerinde saptandı. K. peumoniae
suşlarında ise TZP direnç oranı %41 olarak bulundu. GSBL pozitif bakterilerin
neden olduğu enfeksiyonlarda TZP'nin etkinliğini gösteren yeterli çalışma
bulunmamakla birlikte, mevcut çalışmalar bu antibiyotiklerin etkinliğinin
enfeksiyon bölgesine ve şiddetine göre değiştiğini göstermektedir. PRP sonuç
bildirimi ile ilgili CLSI ve EUCAST arasında bir fikir birliği yoktur. Bu
nedenle, bu konuda daha kapsamlı bir çalışmaya ve TZP'nin sonuç raporunun
yeniden değerlendirilmesine ihtiyaç vardır.

Keywords

Piperasilin-tazobaktam, genişlemiş spektrumlu beta-laktamaz, Escherichia coli

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