High frequency of co-resistance in CTX-M-producing Escherichia coli to non-beta-lactam antibiotics, with the exception of amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin, in a county of Sweden

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Östholm Balkhed, ÅseÖstergötlands Läns Landsting,Linköpings universitet,Klinisk mikrobiologi,Hälsouniversitetet,Infektionskliniken i Östergötland (author)

High frequency of co-resistance in CTX-M-producing Escherichia coli to non-beta-lactam antibiotics, with the exception of amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin, in a county of Sweden

Article/chapterEnglish2013

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2012-10-31
Informa UK Limited,2013
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LIBRIS-ID:oai:DiVA.org:liu-87612
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-87612URI
https://doi.org/10.3109/00365548.2012.734636DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Background: The objective of this study was to investigate the in vitro activity of different antibiotics against CTX-M-producing Escherichia coli in a county of Sweden, and to determine the occurrence of multi-resistance and plasmid- mediated quinolone resistance among these isolates. Methods: A total of 198 isolates of E. coli with extended-spectrum beta-lactamase (ESBL) phenotype and mainly CTX-M genotype were studied. The minimum inhibitory concentrations (MICs) for amikacin, chloramphenicol, ciprofloxacin, colistin, fosfomycin, gentamicin, nalidixic acid, nitrofurantoin, tigecycline, tobramycin, trimethoprim, and trimethoprim-sulfamethoxazole were determined with the Etest. Susceptibility was defined according to the breakpoints of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). MIC(50) and MIC(90) values were calculated. Results: Ninety-five percent or more of the isolates were susceptible to amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin. CTX-M group 9 was more susceptible than CTX-M group 1 to ciprofloxacin, gentamicin, and tobramycin. Sixty-eight percent of the isolates were multi-resistant, and the most common multi-resistance pattern was ESBL phenotype with decreased susceptibility to trimethoprim, trimethoprim-sulfamethoxazole, ciprofloxacin, gentamicin, and tobramycin. Only 1 isolate carried a qnrS1 gene, but 37% carried aac(6')-Ib-cr. Conclusions: A high frequency of co-resistance between ESBL-producing E. coli and non-beta-lactam antibiotics was seen. On the other hand, very high susceptibility was seen for amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin. These data support the replacement of gentamicin and tobramycin, normally used in Sweden, with amikacin, for severe infections.

Subject headings and genre

Etest
minimum inhibitory concentration
extended-spectrum beta-lactamase

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Tärnberg, MariaLinköpings universitet,Medicinsk mikrobiologi,Hälsouniversitetet(Swepub:liu)marta92 (author)
Monstein, Hans-JürgLinköpings universitet,Klinisk mikrobiologi,Infektionsmedicin,Hälsouniversitetet(Swepub:liu)hanmo19 (author)
Hällgren, AnitaÖstergötlands Läns Landsting,Linköpings universitet,Infektionsmedicin,Hälsouniversitetet,Infektionskliniken i Östergötland(Swepub:liu)aniha32 (author)
Hanberger, HåkanÖstergötlands Läns Landsting,Linköpings universitet,Infektionsmedicin,Hälsouniversitetet,Infektionskliniken i Östergötland(Swepub:liu)hakha84 (author)
Nilsson, Lennart E.Linköpings universitet,Klinisk mikrobiologi,Hälsouniversitetet(Swepub:liu)lenni43 (author)
Linköpings universitetKlinisk mikrobiologi (creator_code:org_t)

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In:Scandinavian Journal of Infectious Diseases: Informa UK Limited45:4, s. 271-2780036-55481651-1980

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