Evaluation of the in vitro efficacy of antimicrobials against Enterobacterales with multiple carbapenemase enzymes
Background and Objectives: High-dose of carbapenems and combination therapies with new β-lactam/β-lactamase inhibitors and polymyxin B/tigecycline have been considered for treatment of carbapenem resistant Enterobacterales infection. The research was conducted to evaluate the in vitro potency of am...
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Tehran University of Medical Sciences
2025-06-01
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| Series: | Iranian Journal of Microbiology |
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| Online Access: | https://ijm.tums.ac.ir/index.php/ijm/article/view/5262 |
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| author | Reena Rajan Gopinathan Sasikala |
| author_facet | Reena Rajan Gopinathan Sasikala |
| author_sort | Reena Rajan |
| collection | DOAJ |
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Background and Objectives: High-dose of carbapenems and combination therapies with new β-lactam/β-lactamase inhibitors and polymyxin B/tigecycline have been considered for treatment of carbapenem resistant Enterobacterales infection. The research was conducted to evaluate the in vitro potency of aminoglycosides, ceftazidime/avibactam/aztreonam and tigecycline against isolates of Enterobacteriaceae with multiple carbapenemase enzymes.
Materials and Methods: 42 genotypically confirmed carbapenem resistant Enterobacterales (twenty-nine NDM producers, nine NDM and OXA-48 producers, three NDM and VIM producers and one NDM combined with VIM and OXA 48 producer) were included. Minimum inhibitory concentration for carbapenems, aminoglycosides and tigecycline was determined by Vitek 2. Ceftazidime/avibactam/aztreonam synergy was observed by disk diffusion methodology.
Results: The in vitro efficacy of aminoglycosides was observed against Escherichia coli (E. coli) isolates with NDM and VIM genes. Low tigecycline susceptibility was observed among Klebsiella pneumoniae (K. pneumoniae) isolates with NDM and OXA-48 genes. Ceftazidime -avibactam/aztreonam combination displayed good in vitro activity against dual carbapenemase producers of E. coli isolates (NDM with OXA-48 and NDM with VIM genes) and Klebsiella pneumoniae (combination of NDM, VIM and OXA-48 genes).
Conclusion: Ceftazidime/avibactam/aztreonam, aminoglycosides and tigecycline displayed in vitro activity against dual carbapenemase producers of E. coli and K. pneumoniae.
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| format | Article |
| id | doaj-art-058f6400042e457283f83bc9e16a73af |
| institution | OA Journals |
| issn | 2008-3289 2008-4447 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Microbiology |
| spelling | doaj-art-058f6400042e457283f83bc9e16a73af2025-08-20T02:05:38ZengTehran University of Medical SciencesIranian Journal of Microbiology2008-32892008-44472025-06-0117310.18502/ijm.v17i3.18821Evaluation of the in vitro efficacy of antimicrobials against Enterobacterales with multiple carbapenemase enzymesReena Rajan0Gopinathan Sasikala1Department of Microbiology, Vinayaka Mission's Kirupananda Variyar Medical College and Hospitals, Vinayaka Mission's Research Foundation (Deemed to be University), Salem, Tamil Nadu, IndiaDepartment of Microbiology, Annapoorana Medical College & Hospitals, Salem, Tamil Nadu, India Background and Objectives: High-dose of carbapenems and combination therapies with new β-lactam/β-lactamase inhibitors and polymyxin B/tigecycline have been considered for treatment of carbapenem resistant Enterobacterales infection. The research was conducted to evaluate the in vitro potency of aminoglycosides, ceftazidime/avibactam/aztreonam and tigecycline against isolates of Enterobacteriaceae with multiple carbapenemase enzymes. Materials and Methods: 42 genotypically confirmed carbapenem resistant Enterobacterales (twenty-nine NDM producers, nine NDM and OXA-48 producers, three NDM and VIM producers and one NDM combined with VIM and OXA 48 producer) were included. Minimum inhibitory concentration for carbapenems, aminoglycosides and tigecycline was determined by Vitek 2. Ceftazidime/avibactam/aztreonam synergy was observed by disk diffusion methodology. Results: The in vitro efficacy of aminoglycosides was observed against Escherichia coli (E. coli) isolates with NDM and VIM genes. Low tigecycline susceptibility was observed among Klebsiella pneumoniae (K. pneumoniae) isolates with NDM and OXA-48 genes. Ceftazidime -avibactam/aztreonam combination displayed good in vitro activity against dual carbapenemase producers of E. coli isolates (NDM with OXA-48 and NDM with VIM genes) and Klebsiella pneumoniae (combination of NDM, VIM and OXA-48 genes). Conclusion: Ceftazidime/avibactam/aztreonam, aminoglycosides and tigecycline displayed in vitro activity against dual carbapenemase producers of E. coli and K. pneumoniae. https://ijm.tums.ac.ir/index.php/ijm/article/view/5262EnterobacteralesDual carbapenemaseIn vitro activityMetallobetalactamases |
| spellingShingle | Reena Rajan Gopinathan Sasikala Evaluation of the in vitro efficacy of antimicrobials against Enterobacterales with multiple carbapenemase enzymes Iranian Journal of Microbiology Enterobacterales Dual carbapenemase In vitro activity Metallobetalactamases |
| title | Evaluation of the in vitro efficacy of antimicrobials against Enterobacterales with multiple carbapenemase enzymes |
| title_full | Evaluation of the in vitro efficacy of antimicrobials against Enterobacterales with multiple carbapenemase enzymes |
| title_fullStr | Evaluation of the in vitro efficacy of antimicrobials against Enterobacterales with multiple carbapenemase enzymes |
| title_full_unstemmed | Evaluation of the in vitro efficacy of antimicrobials against Enterobacterales with multiple carbapenemase enzymes |
| title_short | Evaluation of the in vitro efficacy of antimicrobials against Enterobacterales with multiple carbapenemase enzymes |
| title_sort | evaluation of the in vitro efficacy of antimicrobials against enterobacterales with multiple carbapenemase enzymes |
| topic | Enterobacterales Dual carbapenemase In vitro activity Metallobetalactamases |
| url | https://ijm.tums.ac.ir/index.php/ijm/article/view/5262 |
| work_keys_str_mv | AT reenarajan evaluationoftheinvitroefficacyofantimicrobialsagainstenterobacteraleswithmultiplecarbapenemaseenzymes AT gopinathansasikala evaluationoftheinvitroefficacyofantimicrobialsagainstenterobacteraleswithmultiplecarbapenemaseenzymes |