Universität zu Köln

Fuchs, Frieder ORCID: 0000-0001-7075-5378, Ahmadzada, Aysel, Plambeck, Lars, Wille, Thorsten and Hamprecht, Axel ORCID: 0000-0003-1449-5780 (2021). Susceptibility of Clinical Enterobacterales Isolates With Common and Rare Carbapenemases to Mecillinam. Front. Microbiol., 11. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-302X

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Abstract

Purpose: To investigate the susceptibility of carbapenemase-producing Enterobacterales (CPE) to mecillinam based on the recently updated European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints for uncomplicated Urinary Tract Infection (uUTI). Methods: The challenge collection consisted of 105 molecularly characterized Enterobacterales [Klebsiella spp. (N = 49), Escherichia coli (N = 30), Enterobacter cloacae (n = 13), Citrobacter freundii (N = 9), Proteus mirabilis (N = 3), and Raoultella ornithinolytica (N = 1)]. Isolates produced OXA-48 (N = 18), OXA-48-like (N = 18), VIM (N = 22), NDM (N = 22), KPC (N = 12), IMI (N = 9), IMP (N = 6), GES (N = 1), OXA-58 (N = 2) or combinations thereof (N = 5). MICs of carbapenems were determined by agar gradient diffusion (AGD). MICs of mecillinam were assessed by agar dilution (reference method) and compared to disk diffusion (DD) and AGD. Results: Overall 23/105 CPE (21.9%) were susceptible to mecillinam. Susceptibility was observed in E. coli (N = 12), E. cloacae (N = 7), and Klebsiella pneumoniae (N = 4) producing IMI, OXA-48, OXA-48-like, and NDM-1 carbapenemases. MIC50 for mecillinam in all isolates was 128 mg/L while MIC50 for meropenem was 8 mg/L. Lower MICs for mecillinam were found in IMI (MIC50 8 mg/L) and OXA-48-like (MIC50 16 mg/L) producers. The comparison of the different susceptibility methods showed very major errors of 12.2% with AGD and 8.5% with disk diffusion when compared to the reference method. Conclusion: Mecillinam susceptibility was restricted to isolates producing IMI-, OXA-48-like, and NDM-1 carbapenemases and was documented despite high carbapenem MICs in some isolates. Mecillinam could be a promising oral antimicrobial in uUTI caused by E. coli and E. cloacae isolates carrying IMI- and OXA-48-like carbapenemases; however, susceptibility testing by AGD and disk diffusion remains problematic.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fuchs, Frieder UNSPECIFIED orcid.org/0000-0001-7075-5378 UNSPECIFIED Ahmadzada, Aysel UNSPECIFIED UNSPECIFIED UNSPECIFIED Plambeck, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Wille, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamprecht, Axel UNSPECIFIED orcid.org/0000-0003-1449-5780 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-580165
DOI:	10.3389/fmicb.2020.627267
Journal or Publication Title:	Front. Microbiol.
Volume:	11
Date:	2021
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	1664-302X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language URINARY-TRACT-INFECTIONS; PYELONEPHRITIS; MICROBIOLOGY; BACTEREMIA; PRODUCERS; UPDATE Multiple languages Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58016