Universität zu Köln

Plambeck, Lars ORCID: 0000-0003-4481-8405, Fuchs, Frieder ORCID: 0000-0001-7075-5378, Sattler, Janko ORCID: 0000-0003-1415-4169 and Hamprecht, Axel (2022). In vitro activity of mecillinam, temocillin and nitroxoline against MDR Enterobacterales. JAC-Antimicrob. Resist., 4 (3). OXFORD: OXFORD UNIV PRESS. ISSN 2632-1823

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Abstract

Background With increasing resistance to common antibiotics the treatment of urinary tract infections has become challenging and alternative therapeutic options are needed. In the present study, we evaluate the activity of three older and less frequently used antibiotics against MDR Enterobacterales. Methods Susceptibility of mecillinam, temocillin and nitroxoline was assessed in Enterobacterales isolated from urinary specimens with elevated MICs of third-generation cephalosporins. Susceptibility was determined by the recommended reference MIC methods and additionally by disc diffusion. All isolates were characterized for common beta-lactamases by phenotypic and molecular assays. Results In total 394 Enterobacterales were included. The most common resistance mechanisms were ESBLs (n = 273), AmpC (n = 132), carbapenemases [n = 12, including OXA-48-like (n = 8), VIM (n = 2), KPC (n = 1) and NDM (n = 1)] or others (n = 2). Resistance was observed in 59% of isolates to ceftazidime, in 41% to piperacillin/tazobactam and in 54% to ciprofloxacin. In comparison, resistance was less frequent against mecillinam (15%), temocillin (13%) or nitroxoline (2%). Mecillinam showed higher activity in Enterobacter spp., Escherichia coli and in OXA-48-like-producing isolates compared with temocillin, which was more active in Proteus mirabilis and in ESBL-producing isolates. Activity of nitroxoline was high against all isolates, including carbapenemase-producing isolates. Correlation between disc diffusion and MIC methods was good for mecillinam and moderate for temocillin and nitroxoline. Conclusions Mecillinam, temocillin and nitroxoline show good to excellent in vitro activity in MDR Enterobacterales. The activity of mecillinam and temocillin was higher in certain species and restricted depending on beta-lactamase production while nitroxoline showed universally high activity irrespective of species or beta-lactamase present.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Plambeck, Lars UNSPECIFIED orcid.org/0000-0003-4481-8405 UNSPECIFIED Fuchs, Frieder UNSPECIFIED orcid.org/0000-0001-7075-5378 UNSPECIFIED Sattler, Janko UNSPECIFIED orcid.org/0000-0003-1415-4169 UNSPECIFIED Hamprecht, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-677329
DOI:	10.1093/jacamr/dlac059
Journal or Publication Title:	JAC-Antimicrob. Resist.
Volume:	4
Number:	3
Date:	2022
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	2632-1823
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CEPHALOSPORIN-RESISTANT ENTEROBACTERIACEAE; URINARY-TRACT-INFECTIONS; ESCHERICHIA-COLI; MANAGEMENT; BACTEREMIA Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67732