Skip to main content

In vitro activity of temocillin against prevalent extended-spectrum beta-lactamases producing Enterobacteriaceae from Belgian intensive care units


Temocillin is a narrow spectrum penicillin with high stability to most β-lactamases including AmpC types and extended-spectrum types (ESBLs). We have analysed its in vitro activity against 652 clinical isolates of Enterobacteriaceae prospectively collected from patients hospitalised in intensive care units at seven different university hospitals in Belgium in 2005. Strains were screened for ESBL production using cefotaxime and ceftazidime screen agar plates and by double ESBL E-tests. The MIC of temocillin and of five comparators was determined using the E-test method. ESBLs were characterized at one central laboratory by isoelectric focusing, PCR for bla genes of the SHV, TEM, and CTX-M families, and by DNA sequencing. The prevalence of ESBL-producing Enterobacteriaceae averaged 11.8% and ranged between 3.0 and 29% in the different hospitals. Meropenem exhibited the highest in vitro activity overall (mode MIC 0.064 μg; MIC90; 0.19 μg/ml), whereas ceftazidime (MIC90 > 256 μg/ml) and ciprofloxacin (MIC90 > 32 μg/ml) scored the worst. Temocillin was active against more than 90% of the isolates including most AmpC- and ESBL-producing isolates. These data indicate the well preserved activity of temocillin over the years against Enterobacteriaceae and show the wide variation in prevalence of ESBL-producing Enterobacteriaceae isolates in Belgian intensive care units. Prospective clinical studies are, however, needed to validate the usefulness of temocillin in the treatment of microbiologically documented infections caused by ESBL- and/or AmpC- overproducing nosocomial Enterobacteriaceae pathogens.

This is a preview of subscription content, access via your institution.


  1. 1.

    Slocombe B, Cooper CE, Griffin KE, White AR (1985) Temocillin: in vitro antibacterial activity. Drugs 29(Suppl 5):49–56

    PubMed  CAS  Google Scholar 

  2. 2.

    Van Landuyt H, Boelaert J, Piot P, Verbist L (1985) In vitro activity of temocillin against clinical isolates. Drugs 29(Suppl 5):1–8

    PubMed  Article  Google Scholar 

  3. 3.

    Spencer RC (1990) Temocillin. J Antimicrob Chemother 26:735–737

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Taylor RF, Gaya H, Hodson ME (1992) Temocillin and cystic fibrosis: outcome of intravenous administration in patients infected with Pseudomonas cepacia. J Antimicrob Chemother 29:341–344

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Lekkas A, Gyi KM, Hodson ME (2006) Temocillin in the treatment of Burkholderia cepacia infections in cystic fibrosis. J Cyst Fibros 5:121–124

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Vanhoof R, Berhin C, Carpentier M, et al (2001) Comparative in vitro activity of temocillin and other antimicrobial agents against Enterobacteriaceae isolated from patients admitted to five Belgian hospitals. Acta Clin Belg 56:354–359

    PubMed  CAS  Google Scholar 

  7. 7.

    Rodriguez-Villalobos H, Malaviolle V, Frankard J, de Mendonça R, Nonhoff C, Struelens MJ (2006) In vitro activity of temocillin against extended spectrum β-lactamase-producing Escherichia coli. J Antimicrob Chemother 57:771–774

    Google Scholar 

  8. 8.

    Livermore DM, Hope R, Fagan EJ, Warner M, Woodford N, Potz N (2006) Activity of temocillin against prevalent ESBL- and AmpC-producing Enterobacteriaceae from south-east England. J Antimicrob Chemother 57:1012–1014

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Clinical and Laboratory Standards Institute (2006) Performance standards for antimicrobial susceptibility testing. Approved standard MS100-S16. CLSI, Wayne, PA, USA

  10. 10.

    Fuchs PC, Barry AL, Thornsberry C, Jones RN (1985) Interpretive criteria for temocillin disk diffusion susceptibility testing. Eur J Clin Microbiol 4:30–33

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Stürenburg E, Sobottka I, Noor D, Laufs R, Mack D (2004) Evaluation of a new cefepime-clavulanate ESBL Etest to detect extended-spectrum β-lactamases in an Enterobacteriaceae strain collection. J Antimicrob Chemother 54:134–138

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    De Gheldre Y, Avesani V, Berhin C, Delmee M, Glupczynski Y (2003) Evaluation of Oxoid combination discs for detection of extended-spectrum β-lactamases. J Antimicrob Chemother 52:591–597

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    De Gheldre Y, Glupczynski Y, Berhin C et al (2004) Epidemiology of Enterobacter aerogenes in Belgium: results of a multicentre survey. In: Abstracts of the 14th European Congress of Clinical Microbiology and Infectious Diseases. Abstract no. P-1122. Clin Microbiol Infect 10(Suppl 3):305 (abstract)

  14. 14.

    De Gheldre Y, Struelens MJ, Glupczynski Y, et al (2001) National epidemic surveys of Enterobacter aerogenes in Belgian hospitals from 1996 to 1998. J Clin Microbiol 39:889–896

    PubMed  Article  CAS  Google Scholar 

  15. 15.

    Glupczynski Y, Delmée M, Goossens H, Struelens MJ (2001) Distribution and prevalence of antimicrobial resistance among gram-negative isolates in intensive care units in Belgian hospitals between 1996 and 1999. Acta Clin Belg 56:297–306

    PubMed  CAS  Google Scholar 

  16. 16.

    Ieven M, Delmee M, De Mol P et al (2006) Eight years of Belgian MYSTIC surveillance: 1998–2005. In: Abstracts of the 16th European Congress of Clinical Microbiology and Infectious Diseases, Nice, France, April 2006, Abstract no. P-1387

  17. 17.

    Rodriguez-Villalobos H, Malaviolle V, Frankard J et al (2005) Emergence of CTX-M extended-spectrum β-lactamase-producing Escherichia coli in Belgium. Euro-surveillance Weekly 10:63. Available online: (

Download references


This study was supported in part by a grant of Eumedica S.A., Brussels, Belgium. We are indebted to S. Carryn for logistic support in the set up of the studies and for providing the required study material.

Author information



Corresponding author

Correspondence to Y. Glupczynski.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Glupczynski, Y., Huang, TD., Berhin, C. et al. In vitro activity of temocillin against prevalent extended-spectrum beta-lactamases producing Enterobacteriaceae from Belgian intensive care units. Eur J Clin Microbiol Infect Dis 26, 777–783 (2007).

Download citation


  • Ceftazidime
  • Meropenem
  • AmpC
  • Enterobacter Cloaca
  • Temocillin