A Study on Comparative In Vitro Activity of Carbapenem Sparers Against Extended-Spectrum Beta Lactamase–Producing Enterobacteriaceae

    loading  Checking for direct PDF access through Ovid

Abstract

Background

In the era of increasing carbapenem resistance, there is an urgent need to explore alternative options (carbapenem sparers) such as various betalactam/beta-lactamase (BL/BLI) agents, aminoglycosides, fosfomycin, and chloramphenicol to treat infections due to extended-spectrum beta lactamase (ESBL)-producing Enterobacteriaceae. We evaluated the in vitro activities of these agents in comparison to carbapenem against ESBL-producing Enterobacteriaceae blood culture isolates.

Methods

A retrospective analysis on the comparative susceptibility of ESBL-producing Escherichia coli and Klebsiella blood culture isolates against various antibiotics such as cefoperazone-sulbactam, piperacillin-tazobactam, cefepime-tazobactam (C/T), colistin, tigecyline, aminoglycosides, ciprofloxacin, and chloramphenicol was carried out in a tertiary care oncology setting over a span of 18 months (January 2013 to June 2014). Identification of the isolates and susceptibility testing were done using VITEK 2 compact autoanalyzer. Colistin sensitivity was done using Etest, as per Clinical and Laboratory Standards Institute (CLSI) 2013 guidelines.

Results

A total of 125 ESBL E coli and Klebsiella isolates were analyzed, (E coli, 67; Klebsiella, 58). Cefepime-tazobactam and carbapenem sensitivities were similar against E coli as well as Klebsiella isolates. E coli had good sensitivity to amikacin (70%) and chloramphenicol (88.5%). Among all BL/BLI agents, C/T had the highest sensitivity.

Conclusions

Betalactam/beta-lactamase agents and carbapenem had similar susceptibility against ESBL Enterobacteriaceae. Among the BL/BLI combinations, C/T had the highest susceptibility, followed by cefoperazone-sulbactam. Betalactam/beta-lactamase agents may have significant potential as carbapenem sparers.

Related Topics

    loading  Loading Related Articles