Susceptibility of various oral antibacterial agents against extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae.
With the increase in extended spectrum β-lactamase (ESBL)-producing bacteria in the community, cases are often seen in which treatment of infectious diseases with oral antimicrobial agents is difficult. Therefore, we measured the antimicrobial activities of 14 currently available oral antimicrobial agents against ESBL-producing Escherichia coli and Klebsiella pneumoniae. Based on the standard of the Clinical and Laboratory Standards Institute (CLSI), E. coli showed high susceptibility rates of 99.4% to faropenem (FRPM). In terms of fluoroquinolones, the susceptibility rate of E. coli to levofloxacin (LVFX) was low at 32.2%, whereas it showed a good susceptibility rate of 93.1% to sitafloxacin (STFX). With respect to other antimicrobial agents, susceptibility rates to fosfomycin (FOM) and colistin (CL) were more than 90% each, whereas rates of the two antimicrobial agents expected as therapeutic agents, minocycline (MINO) and sulfamethoxazole-trimethoprim (ST), were low at 62.4% and 44.3%, respectively. Based on the CLSI standard, K. pneumoniae showed high susceptibility rates to ceftibuten (CETB) (91.89%), LVFX (86.49%), and STFX (94.6%), indicating that K. pneumoniae showed higher rates than those of E. coli, particularly to fluoroquinolones. Comparison of susceptibility rates according to E. coli genotype showed that many antimicrobial agents existed to which the CTX-M-9 group showed high susceptibility rates. However, there were many agents to which the CTX-M-1 group showed low susceptibility rates, particularly to CETB (51.1%) and LVFX (17.0%). Although there was no significant difference by genotype between FRPM, STFX, and FOM, a significant difference was observed between LVFX, MINO, and ST. Antibiotic-resistant bacteria with highly pathogenic strains have spread in the community, appropriate use of oral antimicrobial agents is required.
Department of Clinical Laboratory, Kobe University Hospital, Hyogo, Japan. Electronic address: nakamurt@med.kobe-u.ac.jp.
Tatsuya
T
Nakamura
Department of Clinical Laboratory Science, Tenri Health Care University, Nara, Japan.
Masaru
M
Komatsu
Department of Clinical Laboratory, Wakayama Rosai Hospital, Wakayama, Japan.
Katsutoshi
K
Yamasaki
Department of Clinical Pathology, Tenri Hospital, Nara, Japan.
Saori
S
Fukuda
Laboratory for Clinical Investigation, Kyoto University Hospital, Kyoto, Japan.
Takeshi
T
Higuchi
Department of Clinical Laboratory, Kyoto Second Red Cross Hospital, Kyoto, Japan.
Tamotsu
T
Ono
Department of Clinical Laboratory, Shiga Medical Center for Adults, Shiga, Japan.
Hisaaki
H
Nishio
Department of Clinical Laboratory, Social Insurance Shiga Hospital, Shiga, Japan.
Noriyuki
N
Sueyoshi
Department of Clinical Laboratory, Japanese Red Cross Otsu Hospital, Shiga, Japan.
Kaneyuki
K
Kida
Department of Medical Technology, Kinki University School of Medicine, Osaka, Japan.
Kaori
K
Satoh
Department of Medical Technology, Kinki University School of Medicine, Osaka, Japan.
Hirofumi
H
Toda
Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan.
Masahiro
M
Toyokawa
Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan.
Isao
I
Nishi
The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan.
Masako
M
Sakamoto
Department of Clinical Laboratory, Osaka Police Hospital, Osaka, Japan.
Masahiro
M
Akagi
Department of Clinical Laboratory, Osaka Police Hospital, Osaka, Japan.
Tetsu
T
Mizutani
Department of Clinical Laboratory, Sumitomo Hospital, Osaka, Japan.
Isako
I
Nakai
Department of Clinical Laboratory, Sumitomo Hospital, Osaka, Japan.
Tomomi
T
Kofuku
Department of Clinical Laboratory, Takarazuka Municipal Hospital, Hyogo, Japan.
Tamaki
T
Orita
Department of Clinical Laboratory, Kobe University Hospital, Hyogo, Japan.
Takuya
T
Zikimoto
Department of Clinical Laboratory, Kansai Medical University Takii Hospital, Osaka, Japan.
Seiko
S
Natsume
Department of Clinical Laboratory, Hyogo Medical University Hospital, Hyogo, Japan.
Yasunao
Y
Wada
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D004926:Escherichia coli / Q000187:drug effects* / Q000378:metabolism; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000378:metabolism; D008826:Microbial Sensitivity Tests / Q000379:methods; D001618:beta-Lactamases / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
CTX-M; ESBL; Enterobacteriaceae; Oral drug