Abstract
Carbapenemase-producing Enterobacteriaceae have become a major public health concern over the last decade and treatment options are limited. We evaluated the synergistic activity of the combination of aztreonam (ATM) and clavulanate for 41 β-lactam-resistant clinical isolates harbouring class B or/and class D carbapenemases combined or not with extended-spectrum β-lactamases (ESBLs). The MICs of ATM, with and without amoxicillin-clavulanate (AMC), were determined. Time-kill assays were performed for three representative strains. The ATM-AMC combination had a synergistic effect on 34/41 (83 %) isolates. The MIC of ATM, in the presence of clavulanate, was ≤1 mg l-1 for 15/41 (37 %) isolates and ≤4 mg l-1 for 29/41 (71 %) isolates. Synergistic activity was observed for 34/37 (92 %) isolates producing ESBLs and carbapenemases, compared to 0/4 (0 %) for ESBL-negative strains. Complete or partial bactericidal activity was obtained when the MIC of the combination was 0.5 mg l-1 and 1.5 mg l-1 or 8 mg l-1, respectively. The combination of ATM and AMC could be an attractive unconventional treatment for infections due to carbapenemase- and ESBL-producing Enterobacteriaceae.
References
Apr 1, 1991·The Journal of Antimicrobial Chemotherapy·J A García-RodríguezE García Sánchez
Jul 1, 1986·Pharmacotherapy·S J Childs, G P Bodey
Aug 1, 1985·Clinical Pharmacology and Therapeutics·G P BodeyB LeBlanc
Jul 1, 1983·Antimicrobial Agents and Chemotherapy·B E ScullyH C Neu
Feb 1, 1996·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·M ArpiB Bruun
Jun 1, 1997·Journal of Chemotherapy·J E García SánchezJ A García-Rodríguez
Jan 7, 1998·Antimicrobial Agents and Chemotherapy·J L Muñoz BellidoJ A García-Rodríguez
Jul 13, 2001·Diagnostic Microbiology and Infectious Disease·C ZemelmanR Zemelman
Nov 1, 2001·Diagnostic Microbiology and Infectious Disease·T S KruegerD E Nix
Jan 13, 2006·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·B BalkeS Häussler
Jan 21, 2011·Journal of Clinical Microbiology·Hélène GarrecJérôme Robert
Apr 27, 2012·Journal of Clinical Microbiology·Edouard BingenRobert Cohen
Jun 4, 2014·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·L S TzouvelekisG L Daikos
Jun 24, 2014·BioMed Research International·Nassima DjahmiJean-Philippe Lavigne
Nov 11, 2015·Antimicrobial Agents and Chemotherapy·Jessica B Cprek, Jason C Gallagher
Nov 26, 2015·The Lancet Infectious Diseases·Yi-Yun LiuJianzhong Shen
Nov 22, 2016·The Lancet Infectious Diseases·Hajo GrundmannUNKNOWN European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group
Feb 16, 2018·Clinical Microbiology Reviews·Jesús Rodríguez-BañoAlvaro Pascual
May 16, 2018·Antimicrobial Agents and Chemotherapy·Ka Lip ChewJeanette W P Teo