Management of infections caused by extended-spectrum β–lactamase-producingEnterobacteriaceae: current evidence and future prospects

Sheu, Chau‐Chyun; Lin, Shang‐Yi; Chang, Ya-Ting; Lee, Chun-Yuan; Chen, Yen-Hsu; Hsueh, Po-Ren

doi:10.1080/14787210.2018.1436966

Cited by 49 publications

(37 citation statements)

References 141 publications

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“…2 The spread of ESBL producing Gramnegative bacilli has increase critically worldwide and is one of the most growing problems of antibiotic resistance and leaves only limited treatment options for clinicians. 3 Moreover, treatment of serious infections with these bacteria is extremely difficult due to co-resistance to multiple antibiotics. 4 Their pathogenicity is multifactorial, including LPS, capsule, adherence factors and exotoxins, and till now, no effective vaccines are developed for protection from these pathogens.…”

Section: Introductionmentioning

confidence: 99%

Antagonistic Activities of Cell-Free Supernatants of Lactobacilli Against Extended-Spectrum β-Lactamase Producing Klebsiella pneumoniae and Pseudomonas aeruginosa

El‐Mokhtar¹,

Hassanein²,

Ahmed³

et al. 2020

IDR

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This study aimed to describe the inhibitory activity of cell-free supernatants (CFS) of lactobacilli against extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae (K pneumoniae) and Pseudomonas aeruginosa (P aeruginosa). Material and Methods: Pathogenic clinical strains of K pneumoniae and P aeruginosa were isolated from urine samples and selected for investigation. Anti-bacterial activities of the CFS of lactobacilli were assessed by agar well diffusion, MTT assay, as well as time-kill tests. In addition, the antibiofilm characteristics were analyzed by the microplate method against fresh and 24 hold biofilms. The ability of CFS to interfere with bacterial invasion was analyzed by flow cytometry. Results: Although all tested strains were ESBL producers and showed a multidrug-resistant phenotype, the CFS displayed a high anti-ESBL activity with inhibition zone diameters greater than 13 mm in the agar well diffusion assays against both pathogens. The growth kinetics of K pneumoniae and P aeruginosa were dramatically decreased in the presence of the CFS. The CFS not only inhibited the biofilm formation by these pathogens but also was able to remove the 24-h formed biofilms. The invasion abilities of FITC-labelled K pneumoniae decreased from 30.3%±7 to 15.4%±5 and invasion of FITC-labelled P aeruginosa was reduced from 36.9%±7 to 25.2%±5. Conclusion: CFS of lactobacilli exhibit anti-ESBL activities, which suggests its potential application for controlling or preventing colonization of infections caused by ESBL-producing bacteria.

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Section: Introductionmentioning

confidence: 99%

Antagonistic Activities of Cell-Free Supernatants of Lactobacilli Against Extended-Spectrum β-Lactamase Producing Klebsiella pneumoniae and Pseudomonas aeruginosa

El‐Mokhtar¹,

Hassanein²,

Ahmed³

et al. 2020

IDR

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“…Carbapenems are the most reliable antibiotics for infections caused by ESBL producing Enterobacteriaceae. However, overuse of these drugs causes the problem of increased drug resistance [5]. Treatment with these antibiotics requires patients to be hospitalized and also increases the cost of treatment [1].…”

Section: Introductionmentioning

confidence: 99%

Fosfomycin in the treatment of extended spectrum beta-lactamase-producing Enterobacteriaceae- related urinary tract infections

Tümtürk

Tonyalı

Tekçe

et al. 2019

J Infect Dev Ctries

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Introduction: We aimed to demonstrate if fosfomycin tromethamine (FT) treatment could be the treatment of choice in ESBL-producing Enterobacteriaceae strains as an alternative to carbapenem particularly in patients who we would like to treat on an outpatient basis. Methodology; We retrospectively analyzed the medical records of all patients who admitted to infectious disease outpatient clinic with complaints of dysuria and frequency and received FT for lower UTI between May 2016 and May 2017. Results: A total of 48 patients, 19 females (39.6%) and 29 males (60.4%), with a mean age of 62.5 (ranging from 27 to 85) years were included the study. 26 (76.4%) of patients with a history of urinary operation or intervention had also a history of antibiotic use within the past 3 months. The isolated pathogens included Escherichia Coli (n = 32), Klebsiella spp. (n = 12), Enterobacter spp. (n = 4). The overall microbiological response after treatment was 70.8% (34/48) and the clinical response was 75% (36/48). Clinical and microbiological response rates of patients with and without urinary operation/intervention, diabetes mellitus, history of antibiotic use and malignancy were found similar (p > 0.05). However, patients with a urinary stone disease history had significantly higher response rates than those without a urinary stone disease history (P = 0.042). Conclusion: Oral fosfomycin tromethamine might be the treatment of choice in ESBL-producing enterobactericea related UTIs especially caused by Escherichia Coli.

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“…Among β-lactam/β-lactamase inhibitor (BLBLI) combinations, the combination of piperacillin–tazobactam (PTZ) has been extensively studied as an alternative carbapenem-sparing option against ESBL-PE infections 12 . In 2012, a meta-analysis compared the mortality rates among carbapenems and alternative regimens, including BLBLIs, for the treatment of ESBL-PE BSIs 13 .…”

Section: Decision Making On Esbl-pe Antimicrobial Treatmentmentioning

confidence: 99%

Treatment of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLs) infections: what have we learned until now?

Pana

Zaoutis

2018

F1000Res

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The spread of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-PE) has dramatically increased worldwide, and this “evolving crisis” is currently regarded as one of the most important public health threats. The growing problem of ESBL-PE antimicrobial resistance seems to have a dual face between “Scylla and Charybdis”: on one hand the potential for rapid spread and dissemination of resistance mechanisms and on the other hand the injudicious overuse of antimicrobial agents and the inadequate infection control measures, especially in the health-care setting. Given the World Health Organization’s warning against a “post antibiotic era”, health-care providers are at a critical standpoint to find a “balance” between safe and effective ESBL-PE treatment and avoidance of inducing further resistance mechanisms. The aim of the review is to summarize the updated published knowledge in an attempt to answer basic everyday clinical questions on how to proceed to effective and the best ESBL-PE treatment options based on the existing published data.

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Management of infections caused by extended-spectrum β–lactamase-producingEnterobacteriaceae: current evidence and future prospects

Cited by 49 publications

References 141 publications

<p>Antagonistic Activities of Cell-Free Supernatants of Lactobacilli Against Extended-Spectrum β-Lactamase Producing <em>Klebsiella pneumoniae</em> and <em>Pseudomonas aeruginosa</em></p>

<p>Antagonistic Activities of Cell-Free Supernatants of Lactobacilli Against Extended-Spectrum β-Lactamase Producing <em>Klebsiella pneumoniae</em> and <em>Pseudomonas aeruginosa</em></p>

Fosfomycin in the treatment of extended spectrum beta-lactamase-producing Enterobacteriaceae- related urinary tract infections

Treatment of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLs) infections: what have we learned until now?

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