Unexpected persistence of extended-spectrum β-lactamase-producing Enterobacteriaceae in the faecal microbiota of hospitalised patients treated with imipenem

International Journal of Antimicrobial Agents
N GrallJ Schrenzel

Abstract

Imipenem is active against extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) but favours the intestinal emergence of resistance. The effects of imipenem on intestinal microbiota have been studied using culture-based techniques. In this study, the effects were investigated in patients using culture and metagenomic techniques. Seventeen hospitalised adults receiving imipenem were included in a multicentre study (NCT01703299, http://www.clinicaltrials.gov). Most patients had a history of antibiotic use and/or hospitalisation. Stools were collected before, during and after imipenem treatment. Bacterial and fungal colonisation was assessed by culture, and microbiota changes were assessed using metagenomics. Unexpectedly, high colonisation rates by imipenem-susceptible ESBL-E before treatment (70.6%) remained stable over time, suggesting that imipenem intestinal concentrations were very low. Carriage rates of carbapenem-resistant Gram-negative bacilli (0-25.0%) were also stable over time, whereas those of yeasts (64.7% before treatment) peaked at 76.5% during treatment and decreased thereafter. However, these trends were not statistically significant. Yeasts included highly diverse colonising Candida spp. Metagenomi...Continue Reading

Citations

Feb 23, 2020·Microorganisms·Benoit PilmisJean-Ralph Zahar
Dec 10, 2019·Current Opinion in Infectious Diseases·Juliette Patrier, Jean-François Timsit
Dec 21, 2017·Microbial Drug Resistance : MDR : Mechanisms, Epidemiology, and Disease·Selina Y L Holbrook, Sylvie Garneau-Tsodikova
Feb 28, 2021·Drug Discovery Today·Antoine AndremontJean de Gunzburg
Mar 23, 2021·Frontiers in Medicine·Michael ThyPhilippe Montravers
Feb 10, 2020·Médecine et maladies infectieuses·A Salmon-RousseauL Piroth
Jan 6, 2022·Annals of Intensive Care·Piotr SzychowiakÉtienne Ruppé

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