Interactions of meropenera, with  -lactamases, including enzymes with extended-spectrum activity against third-generation cephalosporins

1989 ◽  
Vol 24 (suppl A) ◽  
pp. 219-223 ◽  
Author(s):  
R. Labia ◽  
A. Morand ◽  
K. Tiwari ◽  
D. Sirot ◽  
C. Chanal
Keyword(s):  
Third Generation ◽  
Extended Spectrum ◽  
Spectrum Activity ◽  
Third Generation Cephalosporins

scholarly journals Clinical and laboratory differences between extended-spectrum β-lactamase-positive and extended-spectrum β-lactamase-negative bacteria in febrile urinary tract infection in pediatrics

2021 ◽  
Vol 11 (1) ◽  
pp. e2-e2
Author(s):  
Manijeh Kahbazi ◽  
Parsa Yousefichaijan ◽  
Danial Habibi ◽  
Somaie Nejabat ◽  
Amirreza Najmi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Recurrence Rate ◽  
Urine Analysis ◽  
Third Generation ◽  
Extended Spectrum ◽  
First Choice ◽  
Febrile Uti ◽  
History Of ◽  
Tract Infections ◽  
Third Generation Cephalosporins

Introduction: The prevalence of urinary tract infections (UTIs) due to extended-spectrum beta-lactamase (ESBL)-producing bacteria is rising, which needs more potent antibiotics, such as carbapenems. Objectives: To evaluate the clinical and laboratory differences between ESBL-positive and ESBL-negative bacteria in febrile UTI in children between one month to seven years to indicate prognostic parameters for ESBL+ UTI and to suggest appropriate antibiotic treatment. Patients and Methods: This cross-sectional study investigated 282 patients diagnosed with the first febrile UTI. The participants were assigned to ESBL-positive and ESBL-negative UTI groups. The groups were compared based on their clinical and laboratory characteristics and outcomes; the infant group was assessed separately (with the onset age of <3 months). Results: The ESBL UTI was detected in 10.2% of the cases with a history of more frequent hospitalization (P=0.002), longer hospitalization (P=0.04), higher recurrence rate (P=0.003), and more red blood cell count in urine analysis findings (P=0.02). In the antimicrobial susceptibility assay, the ESBL-positive UTI group indicated resistance to third-generation cephalosporins; nevertheless, 93.1% of the cases responded clinically. The infant group showed 13% of the patients with ESBL-positive UTI that was correlated with a history of longer preonset hospital stay (P=0.001), elevated C-reactive protein (CRP) concentration (P=0.002), and elevated recurrence rate (P=0.03), compared to the older group. Conclusion: The ESBL UTI should be further considered due to the resulted recurrence rate. The antimicrobial sensitivity assay indicated resistance to third-generation cephalosporins; however, these drugs are applied as the first choice due to the high response rate. Aminoglycosides are applicable as second choice drugs prior to initiating the use of carbapenems, if third-generation cephalosporins did not indicate bactericidal impacts on ESBL UTI.

scholarly journals Risk Factors for and Outcomes Associated with Clinical Isolates ofEscherichia coliandKlebsiellaSpecies Resistant to Extended-Spectrum Cephalosporins among Patients Admitted to Canadian Hospitals

2009 ◽  
Vol 20 (3) ◽  
pp. e43-e48 ◽  
Author(s):  
Marianna Ofner-Agostini ◽  
Andrew Simor ◽  
Michael Mulvey ◽  
Alison McGeer ◽  
Zahir Hirji ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Care Facility ◽  
P Value ◽  
Third Generation ◽  
Multivariate Logistic Regression ◽  
Extended Spectrum ◽  
Third Generation Cephalosporins

BACKGROUND: Clinical features associated with Gram-negative bacterial isolates with extended-spectrum beta-lactamase (ESBL)- and AmpC-mediated resistance identified in Canadian hospitals is largely unknown. The objective of the present study was to determine the demographics, risk factors and outcomes of patients with ESBL- or AmpC-mediated resistant organisms in Canadian hospitals.METHODS: Patients with clinical cultures ofEscherichia coliorKlebsiellaspecies were matched with patients with a similar organism but susceptible to third-generation cephalosporins. Molecular identification of the AmpC or ESBL was determined using a combination of polymerase chain reaction and sequence analysis. Univariate and multivariate logistic regression analysis was performed to identify variables associated with becoming a case.RESULTS: Eight Canadian hospitals identified 106 cases (ESBL/AmpC) and 106 controls. All risk factors identified in the univariate analysis as a predictor of being an ESBL/AmpC cases at the 0.20 P-value were included in the multivariate analysis. No significant differences in outcomes were observed (unfavourable responses 17% versus 15% and mortality rates 13% versus 7%, P not significant). Multivariate logistic regression found an association of becoming an ESBL/AmpC case with: previous admission to a nursing home (OR 8.28, P=0.01) or acute care facility (OR 1.96, P=0.03), length of stay before infection (OR 3.05, P=0.004), and previous use of first-generation cephalosporins (OR 2.38, P=0.02) or third-generation cephalosporins (OR 4.52, P=0.01). Appropriate antibiotics were more likely to be given to controls (27.0% versus 13.3%, P=0.05) and number of days to appropriate antibiotics was longer for cases (median 2.8 days versus 1.2 days, P=0.05).CONCLUSION: The importance of patient medical history, present admission and antibiotic use should be considered for allE coliorKlebsiellaspecies patients pending susceptibility testing results.

scholarly journals Association between extended-spectrum β-lactamase–producing Escherichia coli and oral third-generation cephalosporins

2021 ◽  
pp. 1-2
Author(s):  
Hiroki Hosokawa ◽  
Satoru Mitsuboshi ◽  
Hirokazu Isobe ◽  
Kenichi Kobayashi ◽  
Hiroshi Moro ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Third Generation ◽  
Extended Spectrum ◽  
Third Generation Cephalosporins

scholarly journals Population Snapshot of the Extended-spectrum β-lactamase-producing Escherichia Coli Invasive Strains Isolated From a Hungarian Hospital

2021 ◽  
Author(s):  
Kinga Tóth ◽  
Ákos Tóth ◽  
Katalin Kamotsay ◽  
Viktória Németh ◽  
Dóra Szabó
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Full Genome Sequence ◽  
Care Hospital ◽  
Third Generation ◽  
E Coli ◽  
Extended Spectrum ◽  
Antimicrobial Resistance Genes ◽  
Antimicrobial Resistance Gene ◽  
Third Generation Cephalosporins

Abstract Background:This study was carried out to determine the prevalence and the genetic background of extended-spectrum β-lactamase-producing Escherichia coli invasive isolates obtained from a tertiary-care hospital in Budapest, Hungary. MethodsBetween October-November 2018, all invasive ESBL-producing E. coli isolates were collected from Central Hospital of Southern Pest. The antimicrobial susceptibility testing was performed according to the EUCAST guidelines. The possible clonal relationships were investigated by core genome (cg)MLST (SeqSphere+) using whole-genome sequencing (WGS) data of isolates obtained from Illumina 251-bp paired-end sequencing. From WGS data acquired antimicrobial resistance genes and replicon types were retrieved using ResFinder3.1, PlasmidFinder2.1, and pMLST-2.0 online tools.ResultsOverall, 25 E. coli isolates were detected and six proved to be resistant to third-generation cephalosporins. Full genome sequence analysis showed that five E. coli isolates belonged to the ST131 clone: two to C1-M27 subclade with blaCTX-M-27 and three to C2/H30Rx subclade with blaCTX-M-15. One isolate belonged to ST1193 with blaCTX-M-27. According to cgMLST, all C2/H30Rx isolates formed a cluster (≤6 allele differences), while the blaCTX-M-27-producing C1-M27 isolates differed at least 35 alleles from each other. Both C2/H30Rx and C1-M27 ST131 isolates harbored similar antimicrobial resistance gene sets. However, only C2/H30Rx isolates had the qnrB and aac(3)-IIa. All isolates showed resistance against ceftriaxone, cefotaxime, and ciprofloxacin, and the C2/H30Rx isolates were also resistant to gentamicin, tobramycin, and ceftazidime.ConclusionsOut of six third-generation cephalosporins-resistant, invasive E. coli, five belonged to the S131clone. This study indicates, that the C2/H30Rx and C1-M27 subclades of the ST131 appear to be the dominant clones collected in a Hungarian hospital.

scholarly journals Detection of a New SHV-Type Extended-Spectrum β-Lactamase, SHV-31, in a Klebsiella pneumoniae Strain Causing a Large Nosocomial Outbreak in The Netherlands

2006 ◽  
Vol 51 (3) ◽  
pp. 1082-1084 ◽  
Author(s):  
A. Mazzariol ◽  
E. Roelofsen ◽  
R. Koncan ◽  
A. Voss ◽  
G. Cornaglia
Keyword(s):  
The Netherlands ◽  
Klebsiella Pneumoniae ◽  
Third Generation ◽  
Nosocomial Outbreak ◽  
Extended Spectrum ◽  
Third Generation Cephalosporins

ABSTRACT A Klebsiella pneumoniae strain resistant to third-generation cephalosporins was isolated in the eastern Netherlands. The strain was found to carry a novel extended-spectrum β-lactamase, namely, SHV-31. The combination of the two mutations by which SHV-31 differs from SHV-1, namely, L35Q and E240K, had previously only been described in association with one or more additional mutations.

Reduced Use of Third-Generation Cephalosporins Decreases the Acquisition of Extended-Spectrum Beta-Lactamase-ProducingKlebsiella pneumoniae

2004 ◽  
Vol 25 (10) ◽  
pp. 832-837 ◽  
Author(s):  
Sang-Oh Lee ◽  
Eun Sun Lee ◽  
Shin Young Park ◽  
Sue-Yun Kim ◽  
Yiel-Hae Seo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Tertiary Care ◽  
Prior Exposure ◽  
Third Generation ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Third Generation Cephalosporins

AbstractObjectives:To identify risk factors for the respiratory acquisition of extended-spectrum beta-lactamase (ESBL)-producingKlebsiella pneumoniaeamong patients admitted to a neurosurgical intensive care unit (NSICU) and to modify them without changing general infection control measures.Design:Nested case-control and intervention study.Setting:A 1,200-bed, tertiary-care teaching hospital with a 17-bed NSICU.Methods:Sputa of all patients admitted to the NSICU were cultured weekly during the study. From October 2002 through February 2003, 29 case-patients from whose sputum ESBL-producingK. pneumoniaewas isolated were detected and 59 controls-patients were randomly selected among patients without any positive isolate of ESBL-producingK. pneumoniae.After analyzing the risk factors, we intervened to modify them and compared the acquisition rate of ESBL-producingK. pneumoniaebefore (October 2002 to February 2003) and after (April to August 2003) the intervention.Results:Multivariate analysis showed that prior exposure to third-generation cephalosporins (TGCs) (OR, 6.0; CI95, 1.9 to 18.6;P= .002) was an independent risk factor of ESBL-producingK. pneumoniaeacquisition. The neurosurgical team was notified of the result, and the infectious diseases specialist visited the NSICU three times a week to regulate TGC use during the intervention period. Patients admitted before the intervention were older than patients admitted after. The respiratory acquisition of ESBL-producingK. pneumoniaeper 1,000 patient-days (13.5 [CI95, 8.9 to 18.1] vs 2.7 [CI95, 0.9 to 4.6]) and the antimicrobial use density of TGCs (38.2 ± 5.0 vs 17.3 ± 2.6;P< .001) decreased significantly after the intervention.Conclusion:Prior exposure to TGCs was an independent risk factor for the respiratory acquisition of ESBL-producingK. pneumoniae,and less use of TGCs was associated with a decrease in acquisition.

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