Cover Image

In Vitro Efficacy of Flomoxef against Extended-Spectrum Beta-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> Associated with Urinary Tract Infections in Malaysia

The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing <i>Enterobacteriaceae</i> has greatly affected the clinical efficacy of β-lactam antibiotics in the management of urinary tract infections (UTIs). The limited treatment options have resulted in the increased use...

Full description

Saved in:
Bibliographic Details
Main Authors: Soo Tein Ngoi (Author), Cindy Shuan Ju Teh (Author), Chun Wie Chong (Author), Kartini Abdul Jabar (Author), Shiang Chiet Tan (Author), Lean Huat Yu (Author), Kin Chong Leong (Author), Loong Hua Tee (Author), Sazaly AbuBakar (Author)
Format: Book
Published: MDPI AG, 2021-02-01T00:00:00Z.
Subjects:
article
Online Access:Connect to this object online.
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing <i>Enterobacteriaceae</i> has greatly affected the clinical efficacy of β-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 β-lactam antibiotics. Fifty <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> 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 µg/mL to 128 µg/mL) for both species. The ESBL genes <i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub> were detected in both <i>E. coli</i> (58% and 54%, respectively) and <i>K. pneumoniae</i> (88% and 74%, respectively), whereas <i>bla</i><sub>SHV</sub> was found only in <i>K. pneumoniae</i> (94%). Carbapenems remained as the most effective antibiotics against ESBL-producing <i>E. coli</i> and <i>K. pneumoniae</i> 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 Description:10.3390/antibiotics10020181
2079-6382

Similar Items