Ngoi, Soo Tein and Teh, Cindy Shuan Ju and Chong, Chun Wie and Abdul Jabar, Kartini and Tan, Shiang Chiet and Yu, Lean Huat and Leong, Kin Chong and Tee, Loong Hua and AbuBakar, Sazaly (2021) In vitro efficacy of flomoxef against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae associated with urinary tract infections in Malaysia. Antibiotics-Basel, 10 (2). ISSN 2079-6382, DOI https://doi.org/10.3390/antibiotics10020181.
Full text not available from this repository.Abstract
The increasing prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae has greatly affected the clinical efficacy of beta-lactam antibiotics in the management of urinary tract infections (UTIs). The limited treatment options have resulted in the increased use of carbapenem. However, flomoxef could be a potential carbapenem-sparing strategy for UTIs caused by ESBL-producers. Here, we compared the in vitro susceptibility of UTI-associated ESBL-producers to flomoxef and established beta-lactam antibiotics. Fifty Escherichia coli and Klebsiella pneumoniae strains isolated from urine samples were subjected to broth microdilution assay, and the presence of ESBL genes was detected by polymerase chain reactions. High rates of resistance to amoxicillin-clavulanate (76-80%), ticarcillin-clavulanate (58-76%), and piperacillin-tazobactam (48-50%) were observed, indicated by high minimum inhibitory concentration (MIC) values (32 mu g/mL to 128 mu g/mL) for both species. The ESBL genes bla(CTX-M) and bla(TEM) were detected in both E. coli (58% and 54%, respectively) and K. pneumoniae (88% and 74%, respectively), whereas bla(SHV) was found only in K. pneumoniae (94%). Carbapenems remained as the most effective antibiotics against ESBL-producing E. coli and K. pneumoniae associated with UTIs, followed by flomoxef and cephamycins. In conclusion, flomoxef may be a potential alternative to carbapenem for UTIs caused by ESBL-producers in Malaysia.
| Item Type: | Article |
|---|---|
| Funders: | University of Malaya Research Fund[RU008-2018], Shionogi Singapore Pte. Ltd. |
| Uncontrolled Keywords: | Antimicrobial resistance;Inhibitor;Broad-spectrum;Lactamase; Resistance gene; Enterobacteriaceae |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 16 Jun 2022 07:28 |
| Last Modified: | 16 Jun 2022 07:28 |
| URI: | http://eprints.um.edu.my/id/eprint/34238 |
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