In vitro efficacy of flomoxef against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae associated with urinary tract infections in Malaysia
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...
Saved in:
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Published: |
MDPI
2021
|
Subjects: | |
Online Access: | http://eprints.um.edu.my/34238/ |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
my.um.eprints.34238 |
---|---|
record_format |
eprints |
spelling |
my.um.eprints.342382022-06-16T07:28:42Z http://eprints.um.edu.my/34238/ In vitro efficacy of flomoxef against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae associated with urinary tract infections in Malaysia Ngoi, Soo Tein Teh, Cindy Shuan Ju Chong, Chun Wie Abdul Jabar, Kartini Tan, Shiang Chiet Yu, Lean Huat Leong, Kin Chong Tee, Loong Hua AbuBakar, Sazaly R Medicine 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. MDPI 2021-02 Article PeerReviewed 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 <https://doi.org/10.3390/antibiotics10020181>. 10.3390/antibiotics10020181 |
institution |
Universiti Malaya |
building |
UM Library |
collection |
Institutional Repository |
continent |
Asia |
country |
Malaysia |
content_provider |
Universiti Malaya |
content_source |
UM Research Repository |
url_provider |
http://eprints.um.edu.my/ |
topic |
R Medicine |
spellingShingle |
R Medicine Ngoi, Soo Tein Teh, Cindy Shuan Ju Chong, Chun Wie Abdul Jabar, Kartini Tan, Shiang Chiet Yu, Lean Huat Leong, Kin Chong Tee, Loong Hua AbuBakar, Sazaly In vitro efficacy of flomoxef against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae associated with urinary tract infections in Malaysia |
description |
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. |
format |
Article |
author |
Ngoi, Soo Tein Teh, Cindy Shuan Ju Chong, Chun Wie Abdul Jabar, Kartini Tan, Shiang Chiet Yu, Lean Huat Leong, Kin Chong Tee, Loong Hua AbuBakar, Sazaly |
author_facet |
Ngoi, Soo Tein Teh, Cindy Shuan Ju Chong, Chun Wie Abdul Jabar, Kartini Tan, Shiang Chiet Yu, Lean Huat Leong, Kin Chong Tee, Loong Hua AbuBakar, Sazaly |
author_sort |
Ngoi, Soo Tein |
title |
In vitro efficacy of flomoxef against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae associated with urinary tract infections in Malaysia |
title_short |
In vitro efficacy of flomoxef against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae associated with urinary tract infections in Malaysia |
title_full |
In vitro efficacy of flomoxef against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae associated with urinary tract infections in Malaysia |
title_fullStr |
In vitro efficacy of flomoxef against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae associated with urinary tract infections in Malaysia |
title_full_unstemmed |
In vitro efficacy of flomoxef against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae associated with urinary tract infections in Malaysia |
title_sort |
in vitro efficacy of flomoxef against extended-spectrum beta-lactamase-producing escherichia coli and klebsiella pneumoniae associated with urinary tract infections in malaysia |
publisher |
MDPI |
publishDate |
2021 |
url |
http://eprints.um.edu.my/34238/ |
_version_ |
1738510716422324224 |
score |
13.164666 |