Antibiotic Options for Treatment of Pediatric Infections with Enterobacteriaceae Producing Broad Spectrum Beta-Lactamases

ISSN: 2211-3533 (Online)
ISSN: 2211-3525 (Print)


Volume 14, 2 Issues, 2016


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Anti-Infective Agents

Formerly: Anti-Infective Agents in Medicinal Chemistry

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Antibiotic Options for Treatment of Pediatric Infections with Enterobacteriaceae Producing Broad Spectrum Beta-Lactamases



Anti-Infective Agents, 10(2): 130-135.

Author(s): Xuan Qin, Emmanouil Galanakis, Danielle M. Zerr and Scott J Weissman.

Affiliation: Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA.

Abstract

Enterobacteriaceae are major pediatric pathogens, but little is known regarding treatment options for multidrug-resistant strains. In this study, we investigated the susceptibility patterns of healthcare- and community-associated Enterobacteriaceae isolates expressing plasmid-borne, broad-spectrum beta-lactam resistance (PBLR). Using E-test methodology, we tested susceptibility to imipenem, meropenem, ertapenem, doripenem, piperacillin-tazobactam, minocycline, tigecycline, fosfomycin, and colistin in all 90 clinical isolates (Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Salmonella enterica) which are derived from urine (n=62), blood (n=12), and other specimens (n=16). These strains are confirmed to carry PBLR determinants. Although malignancy, urogenital and neurological diseases, and multiple antibiotic exposure were present in most patients, twenty three isolates (26%) were characterized as communityassociated. Enterobacteriaceae isolates expressing PBLR retained in vitro susceptibility to colistin (100%), minocycline (72%), tigecycline (97%), and fosfomycin (92%). Five unlinked isolates (6%; two isolates of E. coli and three of K. pneumoniae) showed resistance to one or all carbapenem agents. All community-associated isolates were susceptible to carbapenems and exhibited greater susceptibility to other agents compared to healthcare-associated isolates. In our study population, carbapenems remained broadly active and colistin, fosfomycin, and tigecycline demonstrated therapeutic potential against PBLR-positive isolates. Our findings have implications for susceptibility testing and empirical antimicrobial strategies targeting serious pediatric infections.

Keywords:

Enterobacteriaceae, plasmid-borne, broad-spectrum beta-lactam resistance.



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Article Details

Volume: 10
Issue Number: 2
First Page: 130
Last Page: 135
Page Count: 6
DOI: 10.2174/2211362611208020130
Price: $58
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