Susceptibility of various oral antibacterial agents against extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae

Tatsuya Nakamura; Masaru Komatsu; Katsutoshi Yamasaki; Saori Fukuda; Takeshi Higuchi; Tamotsu Ono; Hisaaki Nishio; Noriyuki Sueyoshi; Kaneyuki Kida; Kaori Satoh; Hirofumi Toda; Masahiro Toyokawa; Isao Nishi; Masako Sakamoto; Masahiro Akagi; Tetsu Mizutani; Isako Nakai; Tomomi Kofuku; Tamaki Orita; Takuya Zikimoto; Seiko Natsume; Yasunao Wada

doi:10.1016/j.jiac.2013.08.004

Susceptibility of various oral antibacterial agents against extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae

J Infect Chemother. 2014 Jan;20(1):48-51. doi: 10.1016/j.jiac.2013.08.004. Epub 2013 Dec 11.

Authors

Tatsuya Nakamura¹, Masaru Komatsu², Katsutoshi Yamasaki³, Saori Fukuda⁴, Takeshi Higuchi⁵, Tamotsu Ono⁶, Hisaaki Nishio⁷, Noriyuki Sueyoshi⁸, Kaneyuki Kida⁹, Kaori Satoh¹⁰, Hirofumi Toda¹⁰, Masahiro Toyokawa¹¹, Isao Nishi¹¹, Masako Sakamoto¹², Masahiro Akagi¹³, Tetsu Mizutani¹³, Isako Nakai¹⁴, Tomomi Kofuku¹⁴, Tamaki Orita¹⁵, Takuya Zikimoto¹⁶, Seiko Natsume¹⁷, Yasunao Wada¹⁸

Affiliations

¹ Department of Clinical Laboratory, Kobe University Hospital, Hyogo, Japan. Electronic address: nakamurt@med.kobe-u.ac.jp.
² Department of Clinical Laboratory Science, Tenri Health Care University, Nara, Japan.
³ Department of Clinical Laboratory, Wakayama Rosai Hospital, Wakayama, Japan.
⁴ Department of Clinical Pathology, Tenri Hospital, Nara, Japan.
⁵ Laboratory for Clinical Investigation, Kyoto University Hospital, Kyoto, Japan.
⁶ Department of Clinical Laboratory, Kyoto Second Red Cross Hospital, Kyoto, Japan.
⁷ Department of Clinical Laboratory, Shiga Medical Center for Adults, Shiga, Japan.
⁸ Department of Clinical Laboratory, Social Insurance Shiga Hospital, Shiga, Japan.
⁹ Department of Clinical Laboratory, Japanese Red Cross Otsu Hospital, Shiga, Japan.
¹⁰ Department of Medical Technology, Kinki University School of Medicine, Osaka, Japan.
¹¹ Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan.
¹² The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan.
¹³ Department of Clinical Laboratory, Osaka Police Hospital, Osaka, Japan.
¹⁴ Department of Clinical Laboratory, Sumitomo Hospital, Osaka, Japan.
¹⁵ Department of Clinical Laboratory, Takarazuka Municipal Hospital, Hyogo, Japan.
¹⁶ Department of Clinical Laboratory, Kobe University Hospital, Hyogo, Japan.
¹⁷ Department of Clinical Laboratory, Kansai Medical University Takii Hospital, Osaka, Japan.
¹⁸ Department of Clinical Laboratory, Hyogo Medical University Hospital, Hyogo, Japan.

PMID: 24462425
DOI: 10.1016/j.jiac.2013.08.004

Abstract

With the increase in extended spectrum β-lactamase (ESBL)-producing bacteria in the community, cases are often seen in which treatment of infectious diseases with oral antimicrobial agents is difficult. Therefore, we measured the antimicrobial activities of 14 currently available oral antimicrobial agents against ESBL-producing Escherichia coli and Klebsiella pneumoniae. Based on the standard of the Clinical and Laboratory Standards Institute (CLSI), E. coli showed high susceptibility rates of 99.4% to faropenem (FRPM). In terms of fluoroquinolones, the susceptibility rate of E. coli to levofloxacin (LVFX) was low at 32.2%, whereas it showed a good susceptibility rate of 93.1% to sitafloxacin (STFX). With respect to other antimicrobial agents, susceptibility rates to fosfomycin (FOM) and colistin (CL) were more than 90% each, whereas rates of the two antimicrobial agents expected as therapeutic agents, minocycline (MINO) and sulfamethoxazole-trimethoprim (ST), were low at 62.4% and 44.3%, respectively. Based on the CLSI standard, K. pneumoniae showed high susceptibility rates to ceftibuten (CETB) (91.89%), LVFX (86.49%), and STFX (94.6%), indicating that K. pneumoniae showed higher rates than those of E. coli, particularly to fluoroquinolones. Comparison of susceptibility rates according to E. coli genotype showed that many antimicrobial agents existed to which the CTX-M-9 group showed high susceptibility rates. However, there were many agents to which the CTX-M-1 group showed low susceptibility rates, particularly to CETB (51.1%) and LVFX (17.0%). Although there was no significant difference by genotype between FRPM, STFX, and FOM, a significant difference was observed between LVFX, MINO, and ST. Antibiotic-resistant bacteria with highly pathogenic strains have spread in the community, appropriate use of oral antimicrobial agents is required.

Keywords: CTX-M; ESBL; Enterobacteriaceae; Oral drug.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / pharmacology*
Escherichia coli / drug effects*
Escherichia coli / metabolism
Klebsiella pneumoniae / drug effects*
Klebsiella pneumoniae / metabolism
Microbial Sensitivity Tests / methods
beta-Lactamases / metabolism*

Substances

Anti-Bacterial Agents
beta-Lactamases