Assessment of doripenem, meropenem, and imipenem against respiratory isolates of Pseudomonas aeroginosa in a tertiary care hospital of north India

Abstract

Objective:Pseudomonas aeruginosa is one of the leading pathogen causing healthcare-associated infections, particularly in immunocompromised and critically ill patients. The development of carbapenem resistance in P. aeruginosa infections is worrisome. Data specifically comparing the susceptibility of the three available carbapenems are lacking in the Indian subcontinent.Materials and Methods:We evaluated the minimum inhibitory concentrations (MICs) of the three commonly used carbapenems– imipenem, meropenem, and doripenem against, 435 P. aeruginosa isolates obtained from respiratory samples and compared their susceptibility patterns to determine the best possible carbapenem among those available that may be used in combination regimes.Results:Overall, 222 (51.0%) of isolates were susceptible to doripenem followed by imipenem 206 (47.3%) and meropenem 195 (44.8%), respectively. Two hundred and sixty-two (60.23%) strains were intermediate or resistant to at least one carbapenem. The MIC90 of all three carbapenems was >32 μg/ml while the MIC50 of meropenem was 16 μg/ml which was higher than MIC50 of both imipenem (4 μg/ml) and doripenem (2 μg/ml).Conclusion:Our study revealed that doripenem exerted better in vitro activity against the tested bacteria compared to imipenem and meropenem, but the difference was not statistically significant.

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“…MIC values of imipenem and meropenem drugs against MDR P. aeruginosa isolates ranged from 8μg/mL to ≥32μg/mL. Our results are consistent with an earlier study in which the MIC of all three carbapenems was >32μg/mL while the MIC of meropenem was 16μg/mL which was greater than MIC of both imipenem (4μg/mL) and doripenem (2μg/mL) (Negi et al, 2017). 63% of carbapenemase producing p. aeruginosa among MDRresistant isolates.…”

Investigation of Virulence Factors and Effect of Chlorine and Sunlight on Carbapenems-Resistant Enterobacteriaceae from Water Samples

“…Kaur, et al [20]also reported a considerable resistance of E. coli and K. pneumoniae to carbapenems drugs. The high resistance profile of bacterial organisms to meropenem as discovered in this study is also reported byLuyt, et al [34]; Negi, et al [30]; Bhatia,et al [35]. The presence of carbapenems-resistant organisms in drinking water sources poses health risk to the users.…”

“…Also, resistance to meropenem and doripenem was observed among the multiple-resistant Escherichiacoli and Klebsiellapneumoniae. This resistance to doripenem and meropenem was reported by Negi, et al [30]. The resistance observed in the organisms could probably be as a result of the three fundamental mechanisms of antimicrobial resistance which are enzymatic degradation of antibacterial drugs, alteration of bacterial proteins that are antimicrobial targets, and changes in membrane permeability to antibiotics [31].…”

Risk factors for carbapenem-resistant Pseudomonas aeruginosa infection or colonization in a Chinese teaching hospital

“…Pseudomonas aeruginosa (PA) is a non-fermenter Gram-negative bacilli, which is one of the most common pathogens associated with nosocomial infections [1]. Carbapenems are commonly used for nosocomial infections, caused by Gram-negative pathogens including PA [2]. However, carbapenemresistant Pseudomonas aeruginosa (CRPA) strains are emerging worldwide, and the rate of resistance in most countries ranges from 10% to 50% [1].…”