The article reviews current options for the treatment of infections caused by carbapenemase-producing Enterobacterales, including the role of aztreonam/avibactam.
- MeSH
- antibakteriální látky * terapeutické užití MeSH
- azabicyklické sloučeniny * terapeutické užití farmakologie MeSH
- aztreonam * terapeutické užití farmakologie MeSH
- Enterobacteriaceae rezistentní na karbapenemy účinky léků MeSH
- enterobakteriální infekce farmakoterapie mikrobiologie MeSH
- fixní kombinace léků MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antibakteriální látky * MeSH
- avibactam MeSH Prohlížeč
- azabicyklické sloučeniny * MeSH
- aztreonam * MeSH
- fixní kombinace léků MeSH
The authors demonstrated the transferability of antibiotic resistance genes in nosocomial strains of Klebsiella pneumoniae, isolated from newborn children at the Paediatric University Hospital in Bratislava. Strains were resistant to cefotaxime, ceftazidime and aztreonam. The determinants of resistance (carbenicillin, cephaloridine, cefotaxime, ceftazidime and aztreonam) were transferred to recipient strains of Escherichia coli K-12 and Proteus mirabilis P-38. The transfer of resistance determinant from donor strains was demonstrated by the analysis of the resistance spectrum in transconjugant clones of recipient strains by the method of indirect selection. The ability of production of extended spectrum beta-lactamases (ESBL) was demonstrated by the double disc diffusion test. Synergy between clavulanate and cefotaxime, clavulanate and ceftazidime and/or clavulanate and aztreonam indicated production of ESBL by these strains.
- MeSH
- aztreonam farmakologie MeSH
- beta-laktamasy biosyntéza MeSH
- beta-laktamová rezistence genetika MeSH
- Klebsiella pneumoniae účinky léků enzymologie genetika izolace a purifikace MeSH
- lidé MeSH
- novorozenec MeSH
- rezistence k cefalosporinům genetika MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- aztreonam MeSH
- beta-laktamasy MeSH
Six Klebsiella pneumoniae strains were collected from two hospitals in Ostrava, Czech republic. Four strains (Nos. 209, 217, 218, 222) were isolated from sputa of critically ill patients from Municipal Hospital Vítkovice-Ostrava. They were resistant to cephalothin, cefotaxime, and ceftazidime (MIC > 100 mg x l-1). Strain No. 218 was intermediately resistant also to ofloxacin and aztreonam (MIC = 12.5 mg x l-1), strain No. 222 was resistant to aztreonam (MIC = 50 mg x l-1). Determinants of resistance to cephalothin, cefotaxime, aztreonam and ceftazidime were transferred to recipient strains of P. mirabilis P-38 rif+ and E. coli K-12 No. 3110 rif+ by all four strains. Synergy between clavulanate-cefotaxime, clavulanate-ceftazidime and clavulanate-aztreonam indicated production of ESBLs by these strains. Two strains, No. 214 and 224, from patients of the ICU in the University Hospital were resistant to cephalothin, cefotaxime and ceftazidime (MIC > 100 mg x l-1). Strain No. 214 was intermediately resistant to aztreonam and ofloxacin (MIC = 12.5 mg x l-1) and strain No. 224 was highly resistant to aztreonam (MIC = 50 mg x l-1). Synergy between clavulanate and cefotaxime as well as between clavulanate and aztreonam, but not between clavulanate and ceftazidime corresponds with non-transferable ceftazidime resistance in strains No. 214 and 224 and indicates different types of ESBL in strains from each of two hospitals.
- MeSH
- aztreonam farmakologie MeSH
- beta-laktamasy metabolismus MeSH
- beta-laktamová rezistence MeSH
- cefalothin farmakologie MeSH
- cefotaxim farmakologie MeSH
- ceftazidim farmakologie MeSH
- infekce bakteriemi rodu Klebsiella mikrobiologie MeSH
- Klebsiella pneumoniae účinky léků izolace a purifikace MeSH
- lidé MeSH
- nemocnice MeSH
- ofloxacin farmakologie MeSH
- rezistence k cefalosporinům MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- aztreonam MeSH
- beta-laktamasy MeSH
- cefalothin MeSH
- cefotaxim MeSH
- ceftazidim MeSH
- ofloxacin MeSH
BACKGROUND: In the last decade were in SR documented new problems in resistance to the newer antibiotics that with regard to their structure and antibacterial properties resisted to the known mechanism of bacterial resistance. The emergence of multiple drug resistance to the new betalactams is connected both with frequent application of these drugs in the hospitals and transfer of R plasmids. METHODS AND RESULTS: We studied composition and transferability of resistance to newer betalactam antibiotics in strains of Acinetobacter sp., Enterobacter sp, and Citrobacter sp. isolated during one month in patients from two teaching University Hospitals. All strains studied were resistant to cefotaxime (CTX), ceftazidime (CAZ) and aztreonam (ATM) but Acinetobacter strains, although resistant also to CAZ and ATM transferred the resistance to CTX only. Thus, resistance to CAZ and ATM has a chromosomal origin in these strains. A strain of Citrobacter sp., resistant to CTX, CAZ and ATM, produced a ESBL betalactamase detectable in a double-disk diffusion method (Fig. 1). An Enterobacter cloacae strain transfers directly the resistance to all new betalactams indicated. Their hydrolysis by these strains points to their production of new types of extended-spectrum beta-lactamases ESBL). CONCLUSIONS: We strongly recommend to be strictly rational in the use of new betalactams of CTX, CZA or ATM type because it is suspected that, especially in so-called empirical prophylaxis or treatment, they exert a strong selective pressure toward the prevalence of mutants with transferable ESBL-producing nosocomial bacteria resistant to these drugs.
- MeSH
- Acinetobacter účinky léků genetika izolace a purifikace MeSH
- antibiotická rezistence MeSH
- aztreonam farmakologie MeSH
- cefalosporiny farmakologie MeSH
- cefotaxim farmakologie MeSH
- ceftazidim farmakologie MeSH
- Citrobacter účinky léků genetika izolace a purifikace MeSH
- Enterobacter účinky léků genetika izolace a purifikace MeSH
- infekce spojené se zdravotní péčí mikrobiologie MeSH
- lidé MeSH
- mnohočetná léková rezistence MeSH
- monobaktamy farmakologie MeSH
- nemocnice univerzitní MeSH
- R-plasmidy * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- aztreonam MeSH
- cefalosporiny MeSH
- cefotaxim MeSH
- ceftazidim MeSH
- monobaktamy MeSH
Six strains of P. aeruginosa, resistant to IMI, CTZ and/or AZA, or to two of these drugs even to all three antibiotics, have been analysed by transduction by standard transducing phages F116 and G101, propagated on these strains, as well by a wildtype phage isolated from one of P. aeruginosa strains resistant to CTZ and AZA. Analysis of occurrence of resistance determinants in individual sets of transductants allows us to conclude that all three antibiotic-resistance determinants are separable by transduction and, thus, the resistance to any of these three antibiotics is genetically governed by independent determinants. None strain, resistant to these antibiotics, could hydrolyse any of these drugs, with an exception of slow hydrolysis of IMI, observed also by other investigators [8]. In contrast, strains hydrolysed classical, first-generation cephalosporins as well as Cefoxitin, and transferability of these two determinants could be proved by transfers, to Enterobacteriaceae (P. aeruginosa are naturally resistant to these two antibiotics). Thus, resistance to IMI, CTZ and/or AZA, is not co-transferred, with determinants of resistance to more classical cephalosporins.
- MeSH
- antibiotická rezistence genetika MeSH
- aztreonam metabolismus farmakologie MeSH
- ceftazidim metabolismus farmakologie MeSH
- hydrolýza MeSH
- imipenem metabolismus farmakologie MeSH
- infekce spojené se zdravotní péčí mikrobiologie MeSH
- lidé MeSH
- pseudomonádové infekce mikrobiologie MeSH
- Pseudomonas aeruginosa účinky léků genetika metabolismus MeSH
- transdukce genetická MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- aztreonam MeSH
- ceftazidim MeSH
- imipenem MeSH
- MeSH
- aztreonam farmakologie MeSH
- bakteriální léková rezistence * MeSH
- ceftazidim farmakologie MeSH
- imipenem farmakologie MeSH
- lidé MeSH
- mnohočetná léková rezistence MeSH
- Pseudomonas aeruginosa účinky léků izolace a purifikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- aztreonam MeSH
- ceftazidim MeSH
- imipenem MeSH
