Clinical isolates of Escherichia coli solely resistant to mecillinam: prevalence and epidemiology

Bousquet, Aurore; Bugier, Sarah; Larréché, Sébastien; Bigaillon, C.; Weber, Philippe; Delacour, Hervé; Valade, Eric; Briel, D. De; Mérens, Audrey

doi:10.1016/j.ijantimicag.2017.11.001

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…To see if there was a relation between known resistance mechanisms other than ESBL-genes and treatment outcomes, whole genome sequences of the 89 ESBL-producing E. coli strains were analysed for the presence of known acquired resistance mechanisms associated with mecillinam resistance, as described by Thulin et al (9) and Bousquet et al (27). lon was the only gene in which non-synonymous mutations were associated with treatment failures.…”

Section: Discussionmentioning

confidence: 99%

“…The raw data were trimmed with Trimmomatic v0.36 (24) and genome assembly was performed using SPAdes v3.11.0 (25). BLAST v2.6.0 (26) was used to identify known antimicrobial resistance genes associated with mecillinam resistance (9,27) in the assembled genomes, and single nucleotide variants (SNVs) in these genes were identified in the positions that were conserved across 20 reference genomes (Genbank accessions: AE014075, CP000819, CP000946, CP000970, CP001164, CP001509, CP001637, CP001665, CP001671, CP001855, CP001969, CP002167, CP002516, CP009072, HG941718, NC_000913, NC_002695, NC_004431, NC_013353, NC_013361). Sequence types (STs), beta-lactamase resistance genes and virulence genes were identified from the raw data using SRST2 v.0.2.0 (28).…”

Section: Whole Genome Sequencing and Bioinformatic Analysesmentioning

confidence: 99%

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Microbial risk factors for treatment failure of pivmecillinam in community‐acquired urinary tract infections caused by ESBL‐producing Escherichia coli

Syre

Hetland

Bernhoff

et al. 2020

APMIS

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Heidi Syre (HS), Marit Andrea Klokkhammer Hetland (MAKH), Eva Bernhoff (EB), Marianne Bollestad (MB), Nils Grude (NG), Gunnar Skov Simonsen (GSS), Iren Høyland Löhr (IHL). Microbial risk factors for treatment failure of pivmecillinam in community-acquired urinary tract infections caused by ESBL-producing Escherichia coliObjectives: The aim of this study was to identify microbial phenotypic and/or molecular risk factors for treatment failure of pivmecillinam in community acquired urinary tract infections (ca-UTIs) caused by ESBL-producing E. coli.Methods: Eighty-nine ESBL-producing E. coli isolated from women suffering from ca-UTIs were included. The susceptibilities to mecillinam were determined using MIC gradient strip.Whole genome sequencing was performed on a Miseq platform and genome assembly was performed using SPAdes v3.11.0.Results: Neither mecillinam MICs nor ESBL-genotypes were associated with treatment outcome of patients treated with pivmecillinam. Specific STs, however, showed significant differences in treatment outcome. Patients infected with E. coli ST131 were more likely to experience treatment failure compared to patients infected with non-ST131 (p 0.02) when adjusted for pivmecillinam dose, mecillinam MIC and severity of infection. Patients infected with E. coli ST69 were more often successfully treated compared to patients infected with non-ST69 (p 0.04). Patients infected with blaCTX-M-15 ST131 strains were more likely to experience treatment failure than those infected with non-blaCTX-M-15 ST131 strains (p 0.02).Conclusions: The results suggest that specific STs are associated with the clinical efficacy of pivmecillinam. Further studies with a larger number of strains, including a larger number of mecillinam resistant strains, are needed to confirm these results.

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Section: Discussionmentioning

confidence: 99%

Section: Whole Genome Sequencing and Bioinformatic Analysesmentioning

confidence: 99%

Microbial risk factors for treatment failure of pivmecillinam in community‐acquired urinary tract infections caused by ESBL‐producing Escherichia coli

Syre

Hetland

Bernhoff

et al. 2020

APMIS

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Polymorphism of Type I–F CRISPR/Cas system in Escherichia coli of phylogenetic group B2 and its application in genotyping

Long

et al. 2019

Infection, Genetics and Evolution

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Pivmecillinam, the paradigm of an antibiotic with low resistance rates in Escherichia coli urine isolates despite high consumption

Frimodt‐Møller

Simonsen

Larsen

et al. 2022

Journal of Antimicrobial Chemotherapy

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Objectives Pivmecillinam, the oral version of mecillinam, represents one of the major recommended and used antibiotics for empiric and targeted treatment of urinary tract infections in primary care in Denmark, Norway and Sweden. Mecillinam resistant mutants in Escherichia coli develop easily in vitro, but their fitness cost has been shown to be high. Methods We revisited the resistance and consumption data from the monitoring programmes in the three countries and compared pivmecillinam with ciprofloxacin from 2010 to 2020. Results Mecillinam resistance rates in Escherichia coli remained around 6% in Denmark and Norway relative to a constant consumption in Norway of 1.6–1.8 DID (defined daily doses per 1000 inhabitants per day), and even increasing in Denmark from 1.6 to 2.3 DID. In Sweden resistance was significantly lower at 4% related to the lower consumption of 0.5 DID. For ciprofloxacin, resistance rates fluctuated around 6%–12%, highest in Sweden with the highest consumption (0.8–0.6 DID) and lowest in Denmark (0.55–0.35 DID) and Norway (0.7–0.3 DID), although consumption declined significantly in all three countries. Conclusions Pivmecillinam is an example of an antibiotic, which easily develops resistance in vitro, but apparently can be used broadly in primary care without increase in resistance rates.

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Clinical isolates of Escherichia coli solely resistant to mecillinam: prevalence and epidemiology

Cited by 4 publications

References 20 publications

Microbial risk factors for treatment failure of pivmecillinam in community‐acquired urinary tract infections caused by ESBL‐producing Escherichia coli

Microbial risk factors for treatment failure of pivmecillinam in community‐acquired urinary tract infections caused by ESBL‐producing Escherichia coli

Polymorphism of Type I–F CRISPR/Cas system in Escherichia coli of phylogenetic group B2 and its application in genotyping

Pivmecillinam, the paradigm of an antibiotic with low resistance rates in Escherichia coli urine isolates despite high consumption

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