Temocillin susceptibility by BSAC methodology

Andrews, J. M.; Jevons, G.; Walker, Rebecca; Ashby, J. P.; Fraise, A.P.

doi:10.1093/jac/dkm179

Cited by 21 publications

(10 citation statements)

References 6 publications

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“…According to BSAC, the breakpoints for temocillin are susceptible (≤32 μg/ml) and resistant (>32 μg/ml), and the zone diameter of ≥12 mm and ≤11 mm are defined as susceptible and resistant, respectively. [ 90 ]…”

Section: Introductionmentioning

confidence: 99%

Laboratory detection and clinical implication of oxacillinase-48 like carbapenemase: The hidden threat

Bakthavatchalam

Anandan

Veeraraghavan

2016

J Global Infect Dis

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Carbapenemase producing Gram-negative pathogen is of great concern for physician. The challenging aspects are treatment option and infection control. Monitoring of respective carbapenemase resistance mechanism is necessary to prevent the outbreaks. Currently, the rapid emergence of oxacillinase (OXA-48) like is alarming. Increasing frequency of OXA-48 is seen than the classical carbapenemase (KPC, NDM, IMP, and VIM) across the world. The blaOXA-48 gene is commonly identified in Escherichia coli and Klebsiella pneumoniae. The transferrable plasmid of OXA-48 is associated with rapid spread and inter-species dissemination. In general, OXA-48-like enzymes weakly hydrolyzes both carbapenem and broad spectrum cephalosporins. Except OXA-163, which effectively hydrolyze cephalosporin. This poor hydrolytic profile obscures the detection of OXA-48-like. It may go undetected in routine diagnosis and complicates the treatment option. Co-production of OXA-48-like with CTX-M-15 and other carbapenemase (NDM, VIM) leads to the emergence of multidrug resistant strains.

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Section: Introductionmentioning

confidence: 99%

Laboratory detection and clinical implication of oxacillinase-48 like carbapenemase: The hidden threat

Bakthavatchalam

Anandan

Veeraraghavan

2016

J Global Infect Dis

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“…The time during which free concentration (fT) stayed above a given MIC was calculated by linear interpolation between measured values for the different dosing regimens. Target attainment rate was calculated considering the fT ensuring a coverage of MIC up to 8 mg/L (temocillin breakpoint for systemic infections from the British Society of Antimicrobial Chemotherapy (BSAC) [21]) and 16 mg/L (presumed MIC for >90% of Enterobacteriaceae [22]).…”

Section: Discussionmentioning

confidence: 99%

“…A recent Belgian survey reported MIC 50/90 values of 8/16 mg/L for temocillin against these organisms [22]. Table 4 summarises the proportion of the dosing interval during which the free temocillin concentration remains above an MIC of 8 mg/L (fT >MIC8 ) or 16 mg/L (fT >MIC16 ) taken as tentative susceptibility breakpoint values for temocillin [21,24]. These values ranged from 78% to 90% and from 48% to 71% when considering fT >MIC8 and fT >MIC16 , respectively.…”

Section: Pharmacodynamicsmentioning

confidence: 99%

Thrice-weekly temocillin administered after each dialysis session is appropriate for the treatment of serious Gram-negative infections in haemodialysis patients

Vandecasteele

Bastos

Capron

et al. 2015

International Journal of Antimicrobial Agents

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In patients with end-stage renal disease (ESRD) treated with intermittent haemodialysis, a limited number of antibiotics have been studied for their suitability for parenteral administration after dialysis sessions only in a thrice-weekly regimen. Temocillin is a β-lactam antibiotic with a long half-live and enhanced activity against most Gram-negative bacteria, including extended-spectrum β-lactamase-producers, thus making it an ideal candidate for use in this setting. This study aimed to evaluate the reliability of thrice-weekly parenteral temocillin in haemodialysis patients by characterising the pharmacokinetics of total and free temocillin. Free and total temocillin concentrations were determined with a validated HPLC method in 448 samples derived from 48 administration cycles in 16 patients with ESRD treated with intermittent haemodialysis and temocillin. Pharmacokinetics were non-linear partly due to saturation in protein binding. Median clearance and half-life for the free drug during intradialysis and interdialysis periods were 113 mL/min vs. 26 mL/min and 3.6 h vs. 24 h, respectively, with dialysis extracting approximately one-half of the residual concentration. The free temocillin concentration remained >16 mg/L (MIC90 threshold for most Enterobacteriaceae) during 48%, 67% and 71% of the dosing interval for patients receiving 1 g q24h, 2 g q48h and 3 g q72h, respectively, suggesting appropriate exposure for the two latter therapeutic schemes. Temocillin administered on dialysis days only in a dosing schedule of 2 g q48h and 3 g q72h is appropriate for the treatment of serious and/or resistant Gram-negative infections in patients with ESRD undergoing intermittent haemodialysis. These doses are higher than those previously recommended.

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“…For fosfomycin, Mueller–Hinton agar supplemented with glucose-6-phosphate was used for MIC determination according to the CLSI agar dilution method [ 9 , 10 ]. As there are currently no CLSI breakpoints for temocillin, the MICs to temocillin were performed using the BSAC’s microbroth dilution method [ 11 ] and interpreted according to the BSAC systemic and urinary breakpoints (≤8 mg/L and ≤32 mg/L respectively) [ 8 ]. ESBL detection was confirmed by the combination disks diffusion method according to the CLSI, using cefotaxime/ceftazidime with and without clavulanate [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

“…We thus sought to evaluate the in vitro activity of temocillin and commonly used antimicrobials (including fosfomycin, tigecycline and colistin) against clinical isolates of Enterobacteriaceae in patients with urinary tract infections and/or bacteraemia in Hong Kong hospitals. Most laboratories in this region perform antimicrobial susceptibilities based on the Clinical and Laboratory Standards Institute (CLSI) method, and as the susceptibility to temocillin had been based on the British Society of Antimicrobial Chemotherapy (BSAC)-defined MIC breakpoints for Enterobacteriaceae [ 8 ], we also examined and compared its activity using the microbroth dilution methods according to the CLSI and the BSAC methods.…”

Section: Introductionmentioning

confidence: 99%

Activity of temocillin and 15 other agents, including fosfomycin and colistin, against Enterobacteriaceae in Hong Kong

Lai

Fung

et al. 2017

Eur J Clin Microbiol Infect Dis

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Limited data are available on temocillin susceptibilities in Enterobacteriaceae from Asian countries where antimicrobial resistance is prevalent. The in vitro activities of temocillin and 15 commonly used antimicrobials against 613 non-duplicate blood (n = 310) and urine (with clinically significant bacteriuria; n = 303) isolates of Enterobacteriaceae from patients who attended 3 out of 7 clusters of public hospitals of the Hospital Authority, Hong Kong, during 2015/2016 were tested. Minimum inhibitory concentrations (MICs) were determined by Clinical and Laboratory Standards Institute (CLSI) microbroth dilution (agar dilution with fosfomycin). For temocillin, MICs were also obtained using the British Society of Antimicrobial Chemotherapy (BSAC) microbroth dilution method and interpreted using the BSAC breakpoints. Overall, 93.0% (570) isolates were susceptible to temocillin using BSAC systemic breakpoint (≤8 mg/L) and all except 2 isolates were susceptible using the urinary breakpoint (≤32 mg/L). The extended spectrum beta-lactamase (ESBL) positivity rate was 23.2% (118 out of 508 E. coli, Klebsiella spp., Proteus spp.). Temocillin resistance rate to ESBL-positive isolates was 16.1% using the systemic breakpoint of ≤8 mg/L (MIC50 and MIC90 were 8 mg/L and 16 mg/L respectively). Two isolates (1 E. coli, temocillin MIC 64 mg/L, 1 Klebsiella sp., MIC 32 mg/mL) were resistant to meropenem and possessed the NDM-5 and KPC-2 genes respectively. Other susceptibility rates were: amoxicillin/clavulanate (59.1%), trimethoprim/sulfamethoxazole (62.5%), ciprofloxacin (71.5%), ceftriaxone (75.4%), nitrofurantoin (76.4%), gentamicin (78.3%), cefepime (81.1%), ceftazidime (83.5%), piperacillin/tazobactam (86%), colistin (88.8%), tigecycline (89.4%), fosfomycin (92.8%), ertapenem (99.0%), amikacin (99.2%) and meropenem (99.7%). Temocillin may be a useful alternative for the treatment of infections caused by ESBL and multi-drug-resistant Enterobacteriaceae in Hong Kong, particularly as resistance rates to ciprofloxacin, nitrofurantoin and piperacillin/tazobactam are high.Electronic supplementary materialThe online version of this article (10.1007/s10096-017-3091-8) contains supplementary material, which is available to authorized users

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Temocillin susceptibility by BSAC methodology

Cited by 21 publications

References 6 publications

Laboratory detection and clinical implication of oxacillinase-48 like carbapenemase: The hidden threat

Laboratory detection and clinical implication of oxacillinase-48 like carbapenemase: The hidden threat

Thrice-weekly temocillin administered after each dialysis session is appropriate for the treatment of serious Gram-negative infections in haemodialysis patients

Activity of temocillin and 15 other agents, including fosfomycin and colistin, against Enterobacteriaceae in Hong Kong

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