Activity of carbapenems and tigecycline against ESBL-producing <i>Escherichia coli</i> and <i>Klebsiella</i> spp.

Oliveira, Caio Fernando de; Ferrugem, Fernando; Schmidt, Renan V.; Prá, Daniel; Horta, Jorge André

doi:10.5935/1676-2444.20180007

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Sumário

LABORATORY MEDICINE, BRIEFING COMMUNICATION • J. Bras. Patol. Med. Lab. 54 (1) • Jan-Feb 2018 • https://doi.org/10.5935/1676-2444.20180007 copy

Activity of carbapenems and tigecycline against ESBL-producing Escherichia coli and Klebsiella spp.

Atividade de carbapenêmicos e tigeciclina diante de Escherichia coli e Klebsiella spp. produtoras de ESBL

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The indiscriminate use of carbapenems in the fight against multidrug resistant Gram-negative bacteria leads to the emergence of resistance to these antimicrobial agents. We examine the in vitro activity of carbapenems and tigecycline against ESBL-producing E. coli and Klebsiella spp. isolated in a single hospital at two different periods eight years apart. Overall resistance to carbapenems ranged from 18.7% in 2007 to 19.1% in 2015/2016. We found no isolates resistant to tigecycline, but two intermediary profiles in the 2015/2016 period. Tigecycline is an important option for treating multidrug resistant Gram-negative infections and helps in the fight against global dissemination of resistance to carbapenems.

Key words:
carbapenems; Escherichia coli; Klebsiella

Year of isolation	Species	n (%)	Clinical source				Antimicrobial resistance
Year of isolation	Species	n (%)	Urine	Respiratory tract	Skin wound	Fluids	Ertapenem n (%)	Imipenem n (%)	Meropenem n (%)	Tigecycline n (%)
2007	E. coli	10 (15.6)	9	0	1	0	1 (10)	0 (0)	0 (0)	0 (0)
	K. pneumoniae	51 (79.7)	25	22	2	2	5 (9.8)	2 (3.9)	3 (5.9)	0 (0)
	K. oxytoca	3 (4.7)	0	3	0	0	1 (33.3)	1 (33.3)	1 (33.3)	0 (0)
	Total	64 (100)	34	25	3	2	7 (10.9)	3 (4.7)	4 (6.2)	0 (0)
2015/2016	E. coli	25 (53.2)	23	0	2	0	0 (0)	6 (24)	0 (0)	0 (0)^* * One E. coli and one K. pneumoniae isolate presented MIC = 2 µg/ml (intermediate); fluids are blood (n = 4) and ascitic fluid (n = 1). MIC: minimum inhibitory concentration.
	K. pneumoniae	21 (44.7)	15	3	0	3	2 (9.5)	2 (9.5)	2 (9.5)	0 (0)^* * One E. coli and one K. pneumoniae isolate presented MIC = 2 µg/ml (intermediate); fluids are blood (n = 4) and ascitic fluid (n = 1). MIC: minimum inhibitory concentration.
	K. oxytoca	1 (2.1)	1	0	0	0	0 (0)	0 (0)	0 (0)	0 (0)
	Total	47 (100)	39	3	2	3	2 (4.2)	8 (17)	2 (4.2)	0 (0)

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[1] CORRESPONDING AUTHOR. Caio Fernando de Oliveira, Avenida Independência, 2293, prédio 42, sala 4208; Bairro Universitário; CEP: 96816-501; Santa Cruz do Sul-RS, Brasil; e-mail: caiofarm@yahoo.com.br.