scholarly journals Evaluation of in vitro susceptibility of fosfomycin among Enterobacteriaceae isolates from urine cultures: A study from Puducherry

2019 ◽  
Vol 11 (03) ◽  
pp. 249-252 ◽  
Author(s):  
Srirangaraj Sreenivasan ◽  
Arunava Kali ◽  
M. V. Pravin Charles ◽  
Seetha Kunigal
Keyword(s):  
Susceptibility Testing ◽  
Therapeutic Option ◽  
Resistance Rate ◽  
Urine Samples ◽  
Diffusion Method ◽  
Disc Diffusion Method ◽  
In Vitro Susceptibility ◽  
In Vitro Susceptibility Testing ◽  
Tract Infections

Abstract INTRODUCTION: The increasing drug resistance among Gram-negative uropathogens and a lack of effective oral antibiotics have limited the therapeutic options available for urinary tract infections (UTIs). This shortage of newer antibiotics has paved the way for considering the use of older antibiotics such as fosfomycin. This study aims to evaluate the in vitro susceptibility of Enterobacteriaceae isolates to fosfomycin. MATERIALS AND METHODS: In this descriptive study conducted over a period of 6 months, we processed 1500 urine samples. The Enterobacteriaceae isolates were subjected to in vitro susceptibility testing to fosfomycin, in addition to the regularly used urinary antibiotics, by Kirby–Bauer disc-diffusion method. RESULTS: Of 1500 urine samples processed, 582 samples yielded the growth of pathogens. Enterobacteriaceae accounted for 392 (67.3%) of the isolates. Among these isolates, lower rates of resistance were observed for imipenem (4.1%) and fosfomycin (13.3%). Relatively higher rates of resistance were observed for nitrofurantoin (35.5%) and amikacin (30.9%). Nalidixic acid, norfloxacin, gentamicin, cefotaxime, and cotrimoxazole showed a high resistance rate of 82.7%, 69.6%, 52.3%, 69.1%, and 71.4%, respectively. All antibiotics, except fosfomycin, were in routine clinical use in our hospital. The low resistance (13.3%) to fosfomycin is indicative of its utility as an excellent urinary antibiotic. CONCLUSIONS: Uropathogenic Enterobacteriaceae isolates displayed excellent in vitro susceptibility to fosfomycin. These in vitro findings suggest the unexplored potential of fosfomycin as a superior therapeutic option for treating uncomplicated UTI.

Mecillinam: Old Molecule, New Option

2018 ◽  
Vol 13 (03) ◽  
pp. 229-233
Author(s):  
Mevliye Yetik ◽  
Fulya Bayındır Bilman
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Susceptibility Testing ◽  
Diffusion Method ◽  
First Line ◽  
Disk Diffusion Method ◽  
In Vitro Susceptibility ◽  
E Coli ◽  
Tract Infections

Background Mecillinam is a β-lactam antibiotic that is increasingly being used for the treatment of uncomplicated urinary tract infections. Nevertheless, the international guidelines still recommend nitrofurantoin, fosfomycin trometamol, and pivmecillinam as first-line agents in the treatment of such infections. Aim The objective of this study was to determine the in vitro efficacy of mecillinam against Escherichia coli and Klebsiella pneumoniae strains isolated from children with urinary tract infections. Materials Methods We investigated E. coli and K. pneumoniae isolates, obtained within the period from January 2016 to October 2017, from urine samples of patients aged 0 to 16 years. Antibiotics susceptibility testing was conducted through the disk diffusion method based on the guidelines provided by EUCAST (European Committee on Antimicrobial Susceptibility Testing). Extended-spectrum β-lactamase (ESBL)-positivity was detected by the double-disk synergy test. Isolates with mecillinam inhibition-zone diameter breakpoints lower than < 15 mm were considered to be resistant according to EUCAST criteria. Results A total of 450 isolates were assessed in the study, 135 of which were ESBL-producing E.coli, 230 were non-ESBL-producing E. coli, 35 were ESBL-producing K. pneumoniae, and 50 were non-ESBL-producing K. pneumoniae isolates. Mecillinam susceptibility was observed in most of the non-ESBL-producing and ESBL-producing E. coli isolates (230/230, 100% and 115/135, 85.1%, respectively). The rates of susceptibility of the non-ESBL-producing and ESBL-producing K. pneumoniae isolates were 37/50 (74%) and 24/35 (68.6%), respectively. Conclusion The in vitro susceptibility results obtained support the usage of mecillinam as a first-line agent. The high susceptibility of non-ESBL-producing E. coli and K. pneumoniae isolates established in vitro brings the hope that this antibiotic could soon be used in clinical practice in Turkey.

scholarly journals Atypical clinical and laboratory features of fish-tank granuloma: A case report

2018 ◽  
Vol 6 ◽  
pp. 2050313X1880407 ◽  
Author(s):  
Michael Sander ◽  
Judith L Isaac-Renton ◽  
Megan A Sander
Keyword(s):  
Case Report ◽  
Susceptibility Testing ◽  
Mycobacterium Marinum ◽  
In Vitro Susceptibility ◽  
Laboratory Features ◽  
In Vitro Susceptibility Testing ◽  
Fish Tank ◽  
Fish Tank Granuloma

We report a case of cutaneous Mycobacterium marinum infection with the unusual reported features of pruritus and paresthesia. In addition, we report a lack of in-vivo response to antibiotics based on in-vitro susceptibility testing.

scholarly journals In Vitro Comparative Efficacy of Voriconazole and Itraconazole against Fluconazole-Susceptible and -Resistant Cryptococcus neoformans Isolates

1998 ◽  
Vol 42 (2) ◽  
pp. 471-472 ◽  
Author(s):  
M. Hong Nguyen ◽  
Christine Y. Yu
Keyword(s):  
Cryptococcus Neoformans ◽  
Susceptibility Testing ◽  
Clinical Isolates ◽  
Comparative Efficacy ◽  
In Vitro Susceptibility ◽  
In Vitro Susceptibility Testing ◽  
Fluconazole Resistant ◽  
Dose Dependent

ABSTRACT In vitro susceptibility testing for 50 clinical isolates of fluconazole-susceptible or -resistant Cryptococcus neoformans was performed with itraconazole and voriconazole. Voriconazole was more potent than itraconazole for fluconazole-susceptible isolates and as potent as itraconazole for fluconazole-susceptible dose-dependent isolates and for fluconazole-resistant isolates. For fluconazole-resistant isolates, the voriconazole and itraconazole MICs ranged from 1 to 2 μg/ml.

scholarly journals Current and Emerging Azole Antifungal Agents

1999 ◽  
Vol 12 (1) ◽  
pp. 40-79 ◽  
Author(s):  
Daniel J. Sheehan ◽  
Christopher A. Hitchcock ◽  
Carol M. Sibley
Keyword(s):  
Fungal Pathogens ◽  
Antifungal Agents ◽  
Susceptibility Testing ◽  
Fungal Infections ◽  
Mechanisms Of Action ◽  
Current Status ◽  
In Vitro Susceptibility ◽  
Clinical Resistance ◽  
In Vitro Susceptibility Testing

SUMMARY Major developments in research into the azole class of antifungal agents during the 1990s have provided expanded options for the treatment of many opportunistic and endemic fungal infections. Fluconazole and itraconazole have proved to be safer than both amphotericin B and ketoconazole. Despite these advances, serious fungal infections remain difficult to treat, and resistance to the available drugs is emerging. This review describes present and future uses of the currently available azole antifungal agents in the treatment of systemic and superficial fungal infections and provides a brief overview of the current status of in vitro susceptibility testing and the growing problem of clinical resistance to the azoles. Use of the currently available azoles in combination with other antifungal agents with different mechanisms of action is likely to provide enhanced efficacy. Detailed information on some of the second-generation triazoles being developed to provide extended coverage of opportunistic, endemic, and emerging fungal pathogens, as well as those in which resistance to older agents is becoming problematic, is provided.

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