Could chloramphenicol be used against ESKAPE pathogens? A review of<i>in vitro</i>data in the literature from the 21st century

Čivljak, Rok; Giannella, Maddalena; Bella, Stefano Di; Petrosillo, Nicola

doi:10.1586/14787210.2014.878647

Cited by 42 publications

(24 citation statements)

References 112 publications

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“…Chloramphenicol was used in seven patients in combination with an another agent; the drug has variable sensitivity in different studies. [222324] Fosfomycin was used as intravenously in four patients in whom it was found to be susceptible. Only one patient who received a combination of tigecycline and ciprofloxacin cleared bacteremia and improved.…”

Section: Discussionmentioning

confidence: 99%

A study of 24 patients with colistin-resistant Gram-negative isolates in a tertiary care hospital in South India

Arjun

Gopalakrishnan

Nambi

et al. 2017

Indian Journal of Critical Care Medicine

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Background:As the use of colistin to treat carbapenem-resistant Gram-negative infections increases, colistin resistance is being increasingly reported in Indian hospitals.Materials and Methods:Retrospective chart review of clinical data from patients with colistin-resistant isolates (minimum inhibitory concentration >2 mcg/ml). Clinical profile, outcome, and antibiotics that were used for treatment were analyzed.Results:Twenty-four colistin-resistant isolates were reported over 18 months (January 2014-June 2015). A history of previous hospitalization within 3 months was present in all the patients. An invasive device was used in 22 (91.67%) patients. Urine was the most common source of the isolate, followed by blood and respiratory samples. Klebsiella pneumoniae constituted 87.5% of all isolates. Sixteen (66.6%) were considered to have true infection, whereas eight (33.3%) were considered to represent colonization. Susceptibility of these isolates to other drugs tested was tigecycline in 75%, chloramphenicol 62.5%, amikacin 29.17%, co-trimoxazole 12.5%, and fosfomycin (sensitive in all 4 isolates tested). Antibiotics that were used for treatment were combinations among the following antimicrobials-tigecycline, chloramphenicol, fosfomycin, amikacin, ciprofloxacin, co-trimoxazole, and sulbactam. Among eight patients who were considered to have colonization, there were no deaths. Bacteremic patients had a significantly higher risk of death compared to all nonbacteremic patients (P = 0.014).Conclusions:Colistin resistance among Gram-negative bacteria, especially K. pneumoniae, is emerging in Indian hospitals. At least one-third of isolates represented colonization only rather than true infection and did not require treatment. Among patients with true infection, only 25% had a satisfactory outcome and survived to discharge. Fosfomycin, tigecycline, and chloramphenicol may be options for combination therapy.

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Section: Discussionmentioning

confidence: 99%

A study of 24 patients with colistin-resistant Gram-negative isolates in a tertiary care hospital in South India

Arjun

Gopalakrishnan

Nambi

et al. 2017

Indian Journal of Critical Care Medicine

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“…Resistance to thirdgeneration cephalosporin in Togo, Ghana, Kenya, Malawi, and Mozambique was documented to be very low (with minimum inhibitory concentration higher than common for a susceptible population) and in some cases even totally absent [49,50] . On the contrary, higher levels of resistance in Salmonella enteritidis were observed from these countries [16,38] . The increasing prevalence of MDR among NTS has been linked to perceived competition for an ecological transmission niche between the two NTS serotypes [51] .…”

Section: Multidrug-resistant Salmonellamentioning

confidence: 83%

“…MDR P. aeruginosa is emerging as a clinically significant pathogen not only in resource-limited settings, but also in developed countries [38] . In a study conducted with 558 P. aeruginosa isolates, 73 (13.1%) were MDR [35] .…”

Section: Multidrug-resistant P Aeruginosamentioning

confidence: 99%

Epidemiology of Multidrug-resistant Organisms in Africa

Gulumbe¹,

Faggo²

2019

mjima

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Multidrug-resistant organisms/bacteria (MDROs) have significant health implications that either have not been addressed or received only limited attention, especially in resource-constrained settings such as Africa, where access to newer, often costly antibiotics is limited. Acquisition of MDROs has been linked with poorer clinical outcomes and prolonged hospitalization. The evolution and spread of MDROs is influenced by factors such as selective pressure exerted by indiscriminate use of antimicrobials in both agriculture and medicine, lack of prescribing skills and training, lack of access to rapid and reliable diagnostics, suboptimal surveillance, as well as poor implementation and adherence to prevention measures. Reports indicate increased occurrence of MDROs in Africa, including members of Enterobacteriaceae which are often implicated in bloodstream, urinary tract, abdomen, skin and soft tissue infections. However, serious data limitation and underreporting are major hurdles that continue to hinder our understanding of the impact of antimicrobial resistance. In this review, we sought to address this gap by providing up-to-date data on the epidemiology of MDROs across the continent, including data on their prevalence and current detection and prevention methods.

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“…The absence of acquired resistance genes and the lack of modifications in these regions may imply either a down-regulation of efflux pumps or an alternative resistance mechanism. The synergistic mechanism of polymyxins and chloramphenicol have been extensively studied; however, this finding potentially indicates a novel loss of chloramphenicol resistance upon gaining resistance towards these lipopeptides (36, 37), and is also seen with the octapeptins.…”

Section: Discussionmentioning

confidence: 99%

Octapeptin C4 Induces Less Resistance and Novel Mutations in an Epidemic Carbapenemase-producingKlebsiella pneumoniaeST258 Clinical Isolate Compared to Polymyxins

Pitt

Cao

Butler

et al. 2018

Preprint

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ABSTRACTPolymyxin B and E (colistin) have been pivotal in the treatment of extensively drug-resistant (XDR) Gram-negative bacterial infections, with increasing use over the past decade. Unfortunately, resistance to these antibiotics is rapidly emerging. The structurally-related octapeptin C4 (OctC4) has shown significant potency against XDR bacteria, including against polymyxin-resistant (Pmx-R) strains, but its mode of action remains undefined. We sought to compare and contrast the acquisition of XDR Klebsiella pneumoniae (ST258) resistance in vitro with all three lipopeptides to help elucidate the mode of action of the drugs and potential mechanisms of resistance evolution. Strikingly, 20 days of exposure to the polymyxins resulted in a dramatic (1000-fold) increase in the minimum inhibitory concentration (MIC) for the polymyxins, reflecting the evolution of resistance seen in clinical isolates, whereas for OctC4 only a 4-fold increase was witnessed. There was no cross-resistance observed between the polymyxin - and octapeptin-induced resistant strains. Sequencing revealed previously known gene alterations for polymyxin resistance, including crrB, mgrB, pmrB, phoPQ and yciM, and novel mutations in qseC. In contrast, mutations in mlaDF and pqiB, 1genes related to phospholipid transport, were found in octapeptin-resistant isolates. Mutation effects were validated via complementation assays. These genetic variations were reflected in phenotypic changes to lipid A. Pmx-R isolates increased 4-amino-4-deoxy-arabinose fortification to phosphate groups of lipid A, whereas OctC4 induced strains harbored a higher abundance of hydroxymyristate and palmitoylate. The results reveal a differing mode of action compared to polymyxins which provides hope for future therapeutics to combat the increasingly threat of XDR bacteria.

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Could chloramphenicol be used against ESKAPE pathogens? A review ofin vitrodata in the literature from the 21st century

Cited by 42 publications

References 112 publications

A study of 24 patients with colistin-resistant Gram-negative isolates in a tertiary care hospital in South India

A study of 24 patients with colistin-resistant Gram-negative isolates in a tertiary care hospital in South India

Epidemiology of Multidrug-resistant Organisms in Africa

Octapeptin C4 Induces Less Resistance and Novel Mutations in an Epidemic Carbapenemase-producingKlebsiella pneumoniaeST258 Clinical Isolate Compared to Polymyxins

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