In vitro activity of cefpirome against selected clinical enterobacterial isolates with β-lactamase-mediated resistance (original) (raw)
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Infection, 1995
Previous studies have shown that there is a high incidence of resistance to cephalosporins among enterobacteria isolated in Greek hospitals. This resistance is mainly due to either the derepression of chromosomal cephalosporinases or the acquisition of plasmids coding for SHV-5 type 13-1actamase. In the present study the activity of cefpirome against a number of enterobacteria (Escherichia coil, Klebsiella pneumoniae, Enterobacter cloacae, Enterobacter aerogenes and Serratia marcescens) possessing the mechanisms mentioned above was examined. Cefpirome was found active against all the strains characterized by stable derepression of chromosomal dass-C enzymes. The antibiotic was less potent against strains expressing SHV-5 type [3-1actamase due to its hydrolysis by the enzyme. Also cefpirome exhibited good activity against E. aerogenes strains with reduced susceptibility to imipenem. These in vitro data suggest that cefpirome might be useful in treating infections caused by these resistant microorganisms that are frequently encountered in Greek hospitals.
Antimicrobial Agents and Chemotherapy, 1989
One hundred clinical isolates resistant to ceftazidime and/or cefotaxime were examined for susceptibility to cefepime. The most frequently encountered ceftazidime-cefotaxime-resistant strains belonged to the genera Enterobacter, Pseudomonas, and Citrobacter. Among these strains, 92% were resistant to cefoperazone, 91% were resistant to cefotaxime, 84% were resistant to ceftazidime, and 6% were resistant to cefepime. Of the members of the family Enterobacteriaceae, 57% were resistant to ceftriaxone. The six strains resistant to cefepime were all Pseudomonas aeruginosa and were resistant to both cefotaxime and ceftazidime. Cefepimeresistant P. aeruginosa strains had exceptionally high levels of P-lactamase activity, higher than the levels found in strains resistant to ceftazidime but susceptible to cefepime. The P-lactamases from the cefepime-resistant strains were type I (Richmond-Sykes), were constitutively produced, and did not have increased affinity or hydrolytic activity for cefepime. Thus, cefepime was active against most gram-negative bacteria which have developed resistance to the broad-spectrum cephalosporins, and resistance to cefepime in P. aeruginosa appears to be associated with higher I-lactamase levels than in cefepime-susceptible strains. Resistance to broad-spectrum cephalosporins was reported early during their clinical use; e.g., strains of Enterobacter, Serratia, and Pseudomonas species that are resistant to ceftazidime and cefotaxime have emerged during therapy with these antibiotics (1, 7, 13). These strains were resistant to multiple P-lactam antibiotics, including all of the broadspectrum cephalosporins. In general, these organisms possess chromosomally mediated P-lactamases (16). Although it was initially perceived that the broad-spectrum cephalosporins were P-lactamase stable, hydrolysis of
In vitro susceptibility pattern of cephalosporin-resistant Gram-negative bacteria
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2008
To determine the in vitro activity of various antimicrobial agents including ertapenem, imipenem, meropenem, fosfomycin, netilmicin, colistin, and piperacillin/tazobactam against clinical isolates of cephalosporin-resistant gram-negative bacteria. All clinical isolates of gram-negative bacteria obtained from patients receiving care at Queen Sirikit National Institute of Child Health (QSNICH), Bangkok, Thailand, from 2006-2007 were evaluated for antimicrobial susceptibility. Those resistant to all cephalosporins were further assessed for additional disc susceptibility and MIC test using E-tests. Each of the fifty-five strains of extended spectrum beta-lactamase (ESBL) producing K. pneumoniae and E. coli were tested. The results showed excellent in vitro activity of the studied drugs against ESBL-producing K. pneumoniae with percent susceptibility of 100, 100, 100, 89.8, and 92.7 for ertapenem, imipenem, meropenem, fosfomycin, and colistin, respectively. MIC90 of ertapenem, imipenem, ...
JPMA. The Journal of the Pakistan Medical Association, 2000
To study the in-vitro antimicrobial activity of Cefpirome: A new fourth generation Cephalosporin in comparison with other agents against clinically significant Gram-negative and Gram-positive bacteria. A multi-center in-vitro study was conducted in 13 centers. Bacterial isolates--A total of 1300 isolates were collected from different clinical laboratories and hospitals at 13 centers. Organisms were identified by the API identification systems (API systems, SA Vericeu, France). The age and sex of each patient, type of hospital unit, source of the isolate and genus and species of the bacteria were recorded on standardized report forms. The sensitivity testing was carried out by the "NCCLS (modified Kirby-Bauer) method"--using Mueller-Hinton agar. The results suggest that Cefpirome has a potential clinical advantage against gram-positive and gram-negative bacteria resistant to other third generation cephalosporins. Cefpirome was active against both gram-negative and gram-posi...
In vitro bactericidal activity of cefepime and cefpirome against clinical isolates at Karachi
Antibiotics not only support to alleviate the infections but also facilitate to avert the multiplication of microbes. Due to the irrational use of antibiotics, the resistance of antibiotics has been augmented which results may increase in morbidity and mortality with the span of time. World renowned regulatory bodies like Food and Drug Administration (FDA), Center of Disease Control and Prevention (CDC), and World Health Organization (WHO) vigorously advocate the surveillance of the resistance of antibiotics. During the present study by Kirby-Bauer disk diffusion method 141 clinical isolates of Staphylococcus aureus (n=47, 33.34%), Escherichia coli (n=54, 38.3%), Proteus species (n=26, 18.4%), and Klebsiella pneumoniae (n=14, 9.92%) are evaluated against cefepime and cefpirome which comes of fourth generation cephalosporin. It has been found that cefpirome has better bactericidal activity than cefepime against E. coli and K. pneumoniae while cefepime has been possessed better antibacterial activity against S. aureus and Proteus species which were isolated from respiratory tract infections, blood stream infection, intra-abdominal and urinary tract infections, and skin and soft tissue infections. K. pneumoniae, E. coli, Proteus species, and S. aureus were 34.8%, 26.3%, 11.3%, and 37.7% resistance against cefepime respectively. S. aureus, E. coli, K. pneumoniae, Proteus species has shown 41.4%, 21.7%, 17.6%, and 8.9% resistance against cefpirome correspondingly.
Evaluation Cephalosporins Resistance in Pathogenic Bacteria Isolated Clinically
2020
Third-generation cephalosporins are a class of b-lactam antibiotics that are often used for the treatment of human infections caused by Gram-negative and gram-positive bacteria. This study aimed to detect the pattern of bacterial antibiotic sensitivity to the third generation of cephalosporins that assist doctors with appropriate empirical therapy. Various bacteria isolated clinically from urine, high vaginal swab (cervical swab), ear, and wound samples during the period from November 2019 to March 2020 at Al-Shomali general hospital, Babil, Iraq and a private laboratory in Babil city. A total of 154 patients were involved in this study, samples were processed at the hospital laboratory during this period, a diagnosis and antibiotic sensitivity test have been done by the routine bacteriological diagnosis as well as VITEK 2 system. Three common third-generation cephalosporins; cefotaxime, Cefotazidime, and ceftriaxone are evaluated. Out of these 154 samples, 46 (30%) have bacterial growth. specimens with bacterial growth were taken from urine, cervical swab, ear discharge, and wound infection were 24, 8, 8, and 6 respectively. All 46 isolated bacteria were 100% resistant to cefotaxime and Cefotazidime, while they were 36 (78%) resistant to ceftriaxone. The prevalence of bacterial isolation in different specimens showed a high predominance of enterococcus spp 16 (35%) from the total samples. The current study showed an increasing burden of bacterial resistance to third-generation cephalosporins especially to cefotaxime and Cefotazidime, may due to misuse and inappropriate high administration of these drugs, early detection of development third-generation resistance in patients by restricted clinical monitoring through judicious use of antibiotics. The high rate of resistance observed in small age groups less than 15 years old.
Brazilian Journal of Infectious Diseases, 2006
We examined the drug susceptibility pattern of Gram-negative bacilli to seven new β β β β β-lactams. A total of 277 non-duplicate gramnegative bacilli strains belonging to the Enterobacteriaceae family, Pseudomonas and Acinetobacter species, isolated from various clinical samples were tested for susceptibility to imipenem, piperacillin/tazobactam, cefoperazone/sulbactam, ticarcillin/clavulanate, cefdinir, cefepime and cefpirome with the disk diffusion technique. The percentage resistance was low for imipenem (7.2%), piperacillin/tazobactam (2.8%), cefoperazone/sulbactam (5.4%). However, a high frequency of resistance was observed to ticarcillin/clavulanate (83.9%), cefdinir (70.6%), cefepime (45.5%) and cefpirome (84.4%). We conclude that imipenem, piperacillin/tazobactam and cefoperazone/sulbactam are effective antibiotics in our environment, whereas ticarcillin/clavulanate, cefdinir, cefepime and cefpirome are relatively uneffective.
Brazilian Journal of Microbiology, 2021
Extended-spectrum β-lactamases' (ESBLs) production is the main resistance mechanism to third-generation cephalosporins (TGCs) in gram-negative bacilli. In Argentina, there is a high prevalence of cefotaximase-type ESBLs (CTX-M). For this reason, dissociated resistance phenotype (DRP) displaying a profile of resistance to cefotaxime (CTX) and susceptibility to ceftazidime (CAZ) might be detected. The aims of this study were to determine the prevalence of DRP in Enterobacterales clinical isolates, to characterize the mechanisms responsible for this phenotype and to evaluate the in vitro behaviour against different antibiotics. Sixty Enterobacterales resistant to any TGC were studied, and among them, 25% displayed a DRP. The β-lactamases associated with DRP were 5/11 CTX-M-2, 4/11 CTX-M-14, 1/11 CTX-M-15 and 1/11 CMY-2 in E. coli, 2/3 CTX-M-2 and 1/3 CMY-2 in P. mirabilis and 1/1 CTX-M-14 in K. pneumoniae. Furthermore, CTX-M-2 and CTX-M-14 were related with DRP in both wild-type isolates and the corresponding transconjugants. Time-kill experiments showed CAZ bactericidal activity on CTX-M-2-and CTX-M-14-producing strains and bacterial regrowth in those CMY-2 producers. An opposite behaviour was evident when cefepime (FEP) was used. However, CAZ and gentamicin combination showed a synergistic effect against the CMY-2 producers. We concluded that Enterobacterales with DRP responded differently to CAZ or FEP depending on the type of β-lactamase they possess, suggesting that these cephalosporins could be a therapeutic option. Therefore, the characterization of the involved resistance mechanism might contribute to define the appropriate antibiotic treatment.