Carbapenem antibiotics for serious infections

Hawkey, Peter M.; Livermore, David M.

doi:10.1136/bmj.e3236

Cited by 112 publications

(96 citation statements)

References 30 publications

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“…For instance, temocillin might be an alternative to carbapenems for treatment as well as ␤-lactam/␤-lactam inhibitors such as the promising combination of ceftazidime plus avibactam. Its use may also reduce the median length of hospitalization due to the delay in introducing the appropriate therapy for treating infections due to ESBL-E (16)(17)(18)(19).…”

Section: Rapid Detection Of Esbl Producers From Urinementioning

confidence: 99%

Rapid Detection of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae from Urine Samples by Use of the ESBL NDP Test

2014

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From June to September 2012, 500 urine samples were recovered from patients with urinary tract infections (UTI) due to Gramnegative bacilli (>10 4 leukocytes/ml and >10 5 Gram-negative isolates/ml) who visited the University hospital Bicêtre (France). They were challenged with extended-spectrum-␤-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) using the rapid diagnostic ESBL NDP test. Results of the ESBL NDP test were compared to the results of the double-disc susceptibility test (DDST) performed on solid-agar plates and molecular identification of the ␤-lactamase genes. Among the 450 nonduplicate urine samples, 11.3% were positive for ESBL-E by using the DDST, the ESBL determinants being mostly of the CTX-M type (CTX-M-15) according to molecular testing. Results of the ESBL NDP test were obtained within 15 min. The sensitivity and specificity of the ESBL NDP test were 98% and 99.8%, respectively, whereas the positive and negative predictive values of this test were 98% and 99.8%, respectively. A perfect correlation between cefotaxime resistance and positivity of the ESBL NDP test was observed. Therefore, the ESBL NDP test offers a powerful tool for a rapid identification of ESBL-E and associated resistance to expandedspectrum cephalosporins. It may be useful in particular for guiding first-line antibiotic therapy.

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Section: Rapid Detection Of Esbl Producers From Urinementioning

confidence: 99%

Rapid Detection of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae from Urine Samples by Use of the ESBL NDP Test

2014

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“…For the treatment of serious infections by ESBL producer microorganisms, carbapenems remain as almost only active drug choise [42] . Because of the fact that cephalosporin resistance in Enterobacteriaceae has risen, carbapenem use has increased [43] . This increased use of carbapenems has resulted in carbapenemase enzymes selection which are much more commoner in nonfermenters than in the Enterobacteriaceae.…”

Section: Resistance -Knowledge and Experimentationmentioning

confidence: 99%

“…The spread of extended spectrum βlactamases (ESBLs) in Enterobacteriaceae have resulted cephalosporin resistance to go up [43] . In severe infections with ESBL positive bacteria cephalosporins have not shown good clinical outcomes.…”

Section: Resistance -Knowledge and Experimentationmentioning

confidence: 99%

Methodology in improving antibiotic implementation policies

Özgenç¹

2016

WJM

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The basic requirements of antibiotic prescribing are components of methodology; knowledge, logical reasoning, and analysis. Antimicrobial drugs are valuable but limited resources, different from other drugs and they are among the most commonly prescribed drugs all over the world. They are the only drugs which do not intentionally affect the patient. They affect the pathogens which invade the host. The emergence and spread of antibiotic-resistant pathogens are accelerated by heavy antibiotic usage. The effective antimicrobial stewardship and infection control program have been shown to limit the emergence of antimicrobial-resistant bacteria. In this respect, education for antibiotic prescribing could be designed by going through the steps of scientific methodology. A defined leadership and a coordinated multidisciplinary approach are necessary for optimizing the indication, selection, dosing, route of administration, and duration of antimicrobial therapy. In scenarios, knowledge is also as important as experience for critical decision making as is designated. In this setting, the prevalence and resistance mechanisms of antimicrobials, and their interactions with other drugs need to be observed. In this respect, infectious disease service should play an important role in improving antimicrobial use by giving advice on the appropriate use of antimicrobial agents, and implementing evidencebased guidelines.

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“…Carbapenems, including imipenem (IMP), meropenem (MEM), and ertapenem (ERP) are the last resort for extended-spectrum β-lactamases (ESBLs) producing bacteria (1). Unfortunately, today, the emerging of Carbapenemase-Producing Enterobacteriaceae (CPE) or Carbapenem-Resistant Enterobacteriaceae (CRE) is a concern in the treatment of multidrug-resistant Gramnegative infections (2).…”

Section: Introductionmentioning

confidence: 99%

Emergence of NDM-1-Producing Escherichia coli in Iran

Eyvazi

Hakemi-Vala

Hashemi

et al. 2017

Arch Clin Infect Dis

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Introduction: Carbapenems are a broad-spectrum class of beta-lactam antibiotics, which are used in treatment of multi-drug resistant infections. Unfortunately, global emerging and spreading of carbapenemase, especially New Delhi metallo β lactamase 1 (blaNDM-1), is a concern in the treatment of multi drug-resistant agents. Here, we report the appearance of blaNDM-1producing Escherichia coli (E. coli) in Iran for the first time. Case Presentation: In this study, 2 blaNDM-1producing E. coli strains were isolated from 2 burn wounds of patients in the Motahari hospital, Tehran. The isolates were resistant to carbapenems (imipenem, meropenem and ertapenem) and other common antibiotics except nitrofurantoin. Combined Disk Test showed that the isolates could not produce blaAmpC and blaKPC carbapenemase, whereas they can produce metallo-β-lactamases (MBL). However, genetic detection using Polymerase Chain Reaction amplification with specific primers for blaKPC, blaIMP, blaVIM-1, blaVIM-1 -blaVIM-37, and blaNDM-1genes showed that only the blaNDM-1gene is amplified from the resistant isolates. Further sequencing of PCR products confirmed the presence of the blaNDM-1gene in these isolates. Conclusions:The emerging of blaNDM-1producing E. coli is a new threat for to the health system in Iran, due to the spreading of the blaNDM-1gene among pathogenic bacteria, which resulted in the emergence of multi drug resistant photogenes. Therefore, early identification of these isolates is mandatory.

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Carbapenem antibiotics for serious infections

Cited by 112 publications

References 30 publications

Rapid Detection of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae from Urine Samples by Use of the ESBL NDP Test

Rapid Detection of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae from Urine Samples by Use of the ESBL NDP Test

Methodology in improving antibiotic implementation policies

Emergence of NDM-1-Producing Escherichia coli in Iran

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