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Activity of beta-lactamase inhibitor combinations onEscherichia coli isolates exhibiting various patterns of resistance to beta-lactam agents

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Abstract

The efficacy of the clinically available β-lactam/β-lactamase inhibitor combinations (amoxicillin/clavulanic acid (CA), ticarcillin/CA, amoxicillin/sulbactam, and piperacillin/ tazobactam) was evaluated on 300 amoxicillin-resistantEscherichia coli isolates having the main patterns of β-lactam resistance. The patterns, which reflect the production of various β-lactamase enzymes, were analyzed by a principal component analysis of susceptibility to 11 β-lactam antibiotics or β-lactam/β-lactamase inhibitor combinations. Sixty-two percent of strains were not very susceptible to penicillins, cephalothin, or any β-lactam/β-lactamase inhibitor combinations except for piperacillin/tazobactam; these strains may represent high-level broad-spectrum β-lactamase (so-called penicillinase) production phenotype or inhibitor-resistant TEM-like enzyme production phenotype. Of the strains, 14.7 % were resistant to amoxicillin and ticarcillin compatible with low-level broad-spectrum β-lactamase production phenotype; 5.7 % were cefoxitin resistant and were postulated to present a high-level cephalosporinase production phenotype; and 2.6 % were resistant to cephalothin only, attributable to a low-level cephalosporinase production phenotype. Three percent of strains were intermediate or resistant to cefotaxime and may produce an extended-spectrum β-lactamase, and the remaining strains (12 %), resistant to all tested antibiotics except for cefotaxime and piperacillin/tazobactam, were hypothesized to produce both broad-spectrum β-lactamase plus cephalosporinase. The minimal inhibitory concentration (MIC) for these phenotype patterns indicated that combinations of CA plus amoxicillin or ticarcillin, or sulbactam plus amoxicillin, restored the activity of penicillins against phenotype 1 strains, whereas these combinations remained inactive against the other phenotype strains. Piperacillin plus tazobactam showed the best in vitro effect against the strains of all resistance phenotypes.

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Authors and Affiliations

  1. Laboratoire de Microbiologie, Centre Hospitalo-Universitaire Beaujon, 100 boulevard du Général Leclerc, 92118, Clichy Cédex, France

    D. Vanjak, B. Picard & N. Lambert-Zechovsky

  2. Laboratoire de Microbiologie, Centre Hospitalo-Universitaire Bichat-Claude Bernard, Paris, France

    C. Muller-Serieys & E. Bergogne-Berezin

Authors
  1. D. Vanjak
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  2. C. Muller-Serieys
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  3. B. Picard
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  4. E. Bergogne-Berezin
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  5. N. Lambert-Zechovsky
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Vanjak, D., Muller-Serieys, C., Picard, B. et al. Activity of beta-lactamase inhibitor combinations onEscherichia coli isolates exhibiting various patterns of resistance to beta-lactam agents. Eur. J. Clin. Microbiol. Infect. Dis. 14, 972–978 (1995). https://doi.org/10.1007/BF01691379

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