The Changing Epidemiology of Extended Spectrum Beta-Lactamases (ESBL) Infections of the Urinary Tract Focusing on Clinical Resistance and Therapeutic Options

Antony, Suresh J.

doi:10.5772/21909

Cited by 2 publications

(1 citation statement)

References 80 publications

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“…coli strains were almost absent (3–6). However, the prevalence of Enterobacteriaceae producing ESBLs of the TEM, SHV, and CTX-M types has increased significantly in patients with complicated UTIs (cUTIs) (7–13). …”

Section: Introductionmentioning

confidence: 99%

Pharmacodynamics of Finafloxacin, Ciprofloxacin, and Levofloxacin in Serum and Urine against TEM- and SHV-Type Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae Isolates from Patients with Urinary Tract Infections

Dalhoff

Schubert

Vente

2017

Antimicrob Agents Chemother

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The pharmacodynamics of finafloxacin, ciprofloxacin, and levofloxacin against extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae isolates were compared. Since quinolones lose activity in acidic media, and particularly in urine, their activities were tested in parallel under conventional conditions and in acidic artificial urine. For this purpose, TEM- and SHV-type ESBL-producing Escherichia coli and Klebsiella pneumoniae strains and their wild-type counterparts were exposed in a modified Grasso model to simulated concentrations of drugs in serum and urine following oral doses of either finafloxacin at 800 mg once a day (q.d.), immediate-release ciprofloxacin at 500 mg twice a day (b.i.d.), extended-release ciprofloxacin at 1,000 mg q.d., or levofloxacin at 500 or 750 mg q.d. The concentrations of the drugs in urine were fitted by compartmental modeling. Bacteria were cultivated in Mueller-Hinton broth (MHB) at pH 7.2 or 5.8 or in artificial urine at pH 5.8. Bacteria were counted every 2 h until 10 h and at 24 h; the areas under the bacterial-count–versus–time curves were calculated. It was found that finafloxacin eliminated all strains within 2 h under all the conditions studied. At all doses studied, ciprofloxacin and levofloxacin were highly active against wild-type strains in MHB at pH 7.2 but lost activity in MHB, and particularly in urine, at pH 5.8. Viable counts of ESBL producers were reduced for 6 to 8 h by 3 log10 titers, but the bacteria regrew thereafter. Ciprofloxacin and levofloxacin were almost inactive against the SHV producer grown in artificial urine. We conclude that pharmacodynamic models using artificial urine may mirror the physiology of urinary tract infections more closely than those using conventional media. In contrast to ciprofloxacin and levofloxacin, finafloxacin gained activity in this model at an acidic pH, maintained activity in artificial urine, and was active against TEM and SHV producers.

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Section: Introductionmentioning

confidence: 99%

Pharmacodynamics of Finafloxacin, Ciprofloxacin, and Levofloxacin in Serum and Urine against TEM- and SHV-Type Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae Isolates from Patients with Urinary Tract Infections

Dalhoff

Schubert

Vente

2017

Antimicrob Agents Chemother

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High prevalence of NDM metallo-β-lactamase among ESBL-producing Escherichia coli İsolates

Çetinkol

Sandallı

Calgin

et al. 2017

Acta Microbiologica et Immunologica Hungarica

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Resistance to β-lactams in Enterobacteriaceae has been increasing worldwide. This study aimed to determine the frequency of β-lactamase genes and antibiotic resistance rates of 140 extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolates obtained from urinary tract infection in Ordu Province, Turkey. Isolates were identified by classic methods and by automated system. ESBL production was confirmed by double disk synergy test and antimicrobial susceptibility was investigated by disk diffusion method. All isolates were screened for β-lactamase coding genes from three groups (A, B, and D) by polymerase chain reaction. The highest rate of susceptible isolates was observed for imipenem (IPM, 99.3%) and ertapenem (ETP, 97.9%), and the highest rate of resistant isolates was observed for cefuroxime (97.9%), ceftriaxone (97.2%), and cefazolin (90.7%). In our study, bla CTX-M1-like group was the most prevalent β-lactamase (n = 109), followed by bla TEM (n = 68), bla CTX-M2 (n = 22), and bla SHV (n = 2). By contrast to low resistance rate to IPM and ETP, we determined bla NDM in 31 isolates (22.1%). In co-prevalence of bla NDM-1 and ESBL-coding genes, a low carbapenem resistance was determined. We can confirm that bla CTX-M1-types are still the most frequent β-lactamase coding gene in Turkey. Our study showed the highest prevalence of bla NDM-1 metallo-β-lactamase coding gene in ESBL-producing E. coli.

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The Changing Epidemiology of Extended Spectrum Beta-Lactamases (ESBL) Infections of the Urinary Tract Focusing on Clinical Resistance and Therapeutic Options

Cited by 2 publications

References 80 publications

Pharmacodynamics of Finafloxacin, Ciprofloxacin, and Levofloxacin in Serum and Urine against TEM- and SHV-Type Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae Isolates from Patients with Urinary Tract Infections

Pharmacodynamics of Finafloxacin, Ciprofloxacin, and Levofloxacin in Serum and Urine against TEM- and SHV-Type Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae Isolates from Patients with Urinary Tract Infections

High prevalence of NDM metallo-β-lactamase among ESBL-producing Escherichia coli İsolates

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