{"title":"Evaluation of the in vitro efficacy of antimicrobials against Enterobacterales with multiple carbapenemase enzymes.","authors":"Reena Rajan, Gopinathan Sasikala","doi":"10.18502/ijm.v17i3.18821","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>High-dose of carbapenems and combination therapies with new β-lactam/β-lactamase inhibitors and polymyxin B/tigecycline have been considered for treatment of carbapenem resistant Enterobacterales infection. The research was conducted to evaluate the in vitro potency of aminoglycosides, ceftazidime/avibactam/aztreonam and tigecycline against isolates of <i>Enterobacteriaceae</i> with multiple carbapenemase enzymes.</p><p><strong>Materials and methods: </strong>42 genotypically confirmed carbapenem resistant Enterobacterales (twenty-nine NDM producers, nine NDM and OXA-48 producers, three NDM and VIM producers and one NDM combined with VIM and OXA 48 producer) were included. Minimum inhibitory concentration for carbapenems, aminoglycosides and tigecycline was determined by Vitek 2. Ceftazidime/avibactam/aztreonam synergy was observed by disk diffusion methodology.</p><p><strong>Results: </strong>The in vitro efficacy of aminoglycosides was observed against <i>Escherichia coli (E. coli)</i> isolates with NDM and VIM genes. Low tigecycline susceptibility was observed among <i>Klebsiella pneumoniae (K. pneumoniae)</i> isolates with NDM and OXA-48 genes. Ceftazidime -avibactam/aztreonam combination displayed good in vitro activity against dual carbapenemase producers of <i>E. coli</i> isolates (NDM with OXA-48 and NDM with VIM genes) and <i>Klebsiella pneumoniae</i> (combination of NDM, VIM and OXA-48 genes).</p><p><strong>Conclusion: </strong>Ceftazidime/avibactam/aztreonam, aminoglycosides and tigecycline displayed in vitro activity against dual carbapenemase producers of <i>E. coli</i> and <i>K. pneumoniae.</i></p>","PeriodicalId":14633,"journal":{"name":"Iranian Journal of Microbiology","volume":"17 3","pages":"390-396"},"PeriodicalIF":1.7000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218881/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Iranian Journal of Microbiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18502/ijm.v17i3.18821","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: High-dose of carbapenems and combination therapies with new β-lactam/β-lactamase inhibitors and polymyxin B/tigecycline have been considered for treatment of carbapenem resistant Enterobacterales infection. The research was conducted to evaluate the in vitro potency of aminoglycosides, ceftazidime/avibactam/aztreonam and tigecycline against isolates of Enterobacteriaceae with multiple carbapenemase enzymes.
Materials and methods: 42 genotypically confirmed carbapenem resistant Enterobacterales (twenty-nine NDM producers, nine NDM and OXA-48 producers, three NDM and VIM producers and one NDM combined with VIM and OXA 48 producer) were included. Minimum inhibitory concentration for carbapenems, aminoglycosides and tigecycline was determined by Vitek 2. Ceftazidime/avibactam/aztreonam synergy was observed by disk diffusion methodology.
Results: The in vitro efficacy of aminoglycosides was observed against Escherichia coli (E. coli) isolates with NDM and VIM genes. Low tigecycline susceptibility was observed among Klebsiella pneumoniae (K. pneumoniae) isolates with NDM and OXA-48 genes. Ceftazidime -avibactam/aztreonam combination displayed good in vitro activity against dual carbapenemase producers of E. coli isolates (NDM with OXA-48 and NDM with VIM genes) and Klebsiella pneumoniae (combination of NDM, VIM and OXA-48 genes).
Conclusion: Ceftazidime/avibactam/aztreonam, aminoglycosides and tigecycline displayed in vitro activity against dual carbapenemase producers of E. coli and K. pneumoniae.
期刊介绍：
The Iranian Journal of Microbiology (IJM) is an international, multi-disciplinary, peer-reviewed journal that provides rapid publication of the most advanced scientific research in the areas of basic and applied research on bacteria and other micro-organisms, including bacteria, viruses, yeasts, fungi, microalgae, and protozoa concerning the development of tools for diagnosis and disease control, epidemiology, antimicrobial agents, clinical microbiology, immunology, Genetics, Genomics and Molecular Biology. Contributions may be in the form of original research papers, review articles, short communications, case reports, technical reports, and letters to the Editor. Research findings must be novel and the original data must be available for review by the Editors, if necessary. Studies that are preliminary, of weak originality or merely descriptive as well as negative results are not appropriate for the journal. Papers considered for publication must be unpublished work (except in an abstract form) that is not under consideration for publication anywhere else, and all co-authors should have agreed to the submission. Manuscripts should be written in English.
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