Favourable effect of clavulanic acid on the minimum inhibitory concentrations of cefixime and ceftibuten in ESBL-producing Escherichia coli and Klebsiella pneumoniae

IF 3.7 3区 医学 Q2 INFECTIOUS DISEASES Journal of global antimicrobial resistance Pub Date : 2024-06-28 DOI:10.1016/j.jgar.2024.06.008
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Abstract

Objectives

The use of cephalosporins combined with clavulanate for the treatment of ESBL-harbouring Enterobacteriaceae has been scarcely described. We aimed to describe the effect of different concentrations of clavulanate in the MIC of cefixime and ceftibuten of ESBL-producing Escherichia coli and Klebsiella pneumoniae.

Methods

ESBL-producing E. coli and K. pneumoniae isolates were studied. Fixed concentrations of cefixime and ceftibuten (ranges of 32–0.25 and 64–0.5 ng/ml, respectively) were used. Combinations of cefixime/clavulanate and ceftibuten/clavulanate in different ratios (1:0, 1:1, 2:1, 4:1, 8:1, 16:1, 32:1) were tested. MIC were determined by broth microdilution.

Results

A total of 6 ESBL-producing E. coli, 6 ESBL-producing K. pneumoniae and 2 control E. coli were tested. When different quantities of clavulanate were added to cefixime and ceftibuten, greater than two-fold decreases in the MIC were observed. When testing the 1:1 cefixime/clavulanate ratio, 10/12 isolates were susceptible. When the ratios 2:1, 4:1, 8:1 and 16:1 were tested, susceptibility was noted for 9/12, 8/12, 4/12 and 5/12 isolates, respectively. Only 2/12 K. pneumoniae isolates were susceptible when the ratio 32:1 was tested. When testing ceftibuten/clavulanate, all isolates remained susceptible across all experiments.

Conclusions

Clavulanic acid has a favourable effect in reducing the MIC of cefixime and ceftibuten in isolates of ESBL-producing E. coli and K. pneumoniae. Combining clavulanate with ceftibuten or cefixime could be a useful treatment strategy.

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克拉维酸对头孢克肟和头孢布烯在产 ESBL 大肠埃希菌和肺炎克雷伯菌中的最小抑菌浓度的有利影响。
目的:头孢菌素类药物与克拉维酸联合用于治疗含有 ESBL 的肠杆菌科细菌的情况鲜有报道。我们的目的是描述不同浓度的克拉维酸对头孢克肟和头孢布坦对产 ESBL 大肠埃希菌和肺炎克雷伯菌 MIC 的影响:方法:研究了产ESBL的大肠埃希菌和肺炎克雷伯菌分离株。使用固定浓度的头孢克肟和头孢布烯(范围分别为 32-0.25 和 64-0.5 纳克/毫升)。测试了不同比例(1:0、1:1、2:1、4:1、8:1、16:1、32:1)的头孢克肟/克拉维酸和头孢布烯/克拉维酸组合。肉汤微量稀释法测定 MIC:结果:共检测了 6 个产 ESBL 的大肠杆菌、6 个产 ESBL 的肺炎双球菌和 2 个对照大肠杆菌。在头孢克肟和头孢布烯中添加不同数量的克拉维酸时,观察到其 MIC 下降了两倍多。当测试头孢克肟/克拉维酸的比例为 1:1 时,10/12 个分离菌株对其易感。当测试比例为 2:1、4:1、8:1 和 16:1 时,分别有 9/12、8/12、4/12 和 5/12 个分离菌株对其产生敏感性。当测试比例为 32:1 时,只有 2/12 个肺炎克雷伯菌分离物对其产生敏感性。在测试头孢布烯/克拉维酸时,所有分离菌株在所有实验中均保持易感性:结论:克拉维酸能有效降低头孢克肟和头孢布烯对产 ESBL 大肠杆菌和肺炎双球菌分离株的 MIC。将克拉维酸与头孢布烯或头孢克肟联合使用可能是一种有用的治疗策略。
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来源期刊
Journal of global antimicrobial resistance
Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY
CiteScore
8.70
自引率
2.20%
发文量
285
审稿时长
34 weeks
期刊介绍: The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.
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