Which non-carbapenem antibiotics are active against extended-spectrum β-lactamase-producing Enterobacteriaceae?

Hélène Bouxom (1) , Damien Fournier (1) , Kévin Bouiller (2) , Didier Hocquet (1, 3) , Xavier Bertrand (1, 3)

1 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
2 Service de Réanimation Médicale (CHU de Dijon)
3 LCE - Laboratoire Chrono-environnement (UMR 6249)

We evaluated the activity of 18 non-carbapenem antibiotics on 100 ESBL-producing Escherichia coli (ESBL-Ec) and 50 ESBL-producing Klebsiella pneumoniae (ESBL-Kp) isolated from urinary tract infections and bacteremia in 2016. MICs were determined using reference methods and susceptibility profiles were defined according to the EUCAST 2017 recommendations. All the ESBL-Ec isolates were susceptible to ceftazidime-avibactam and a great majority of them were susceptible to fosfomycin (98%), piperacillin-tazobactam (97%), amikacin (97%) and nitrofurantoin (96%). Mecillinam, cefoxitin and ceftolozane-tazobactam remained against 92, 83 and 78% of the ESBL-Ec isolates, respectively. 100 %, 94%, and 90% of the ESBL-Kp tested were susceptible to ceftazidime-avibactam, amikacin and mecillinam, respectively. We showed that there are non-carbapenem options for the treatment of all the situations of ESBL-Ec or ESBL-Kp infections, with ceftazidime-avibactam being the most attractive alternative.

Mots clés: Klebsiella pneumoniae; Susceptibility; Escherichia coli; Alternatives; Antibiotics; ESBL

Domaines: Microbiologie et Parasitologie

Hélène Bouxom, Damien Fournier, Kévin Bouiller, Didier Hocquet, Xavier Bertrand. Which non-carbapenem antibiotics are active against extended-spectrum β-lactamase-producing Enterobacteriaceae?. International Journal of Antimicrobial Agents, 2018, 52 (1), pp.100-103. ⟨10.1016/j.ijantimicag.2018.03.014⟩. ⟨hal-01812635⟩