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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Main Authors: Reena Rajan, Gopinathan Sasikala
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2025-06-01
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
description 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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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