Session Type: ePosters
Session Title: ePosters
Authors(s): L. Plambeck (1), F. Fuchs (1), A. Hamprecht (1, 2, 3)
Authors Affiliations(s): (1) University of Cologne, Germany, (2) University of Oldenburg, Germany, (3) German Center for Infection research (DZIF), Germany
Background:
Mecillinam and temocillin are beta-lactam antibiotics which have been rediscovered because of their activity against multi-drug resistant (MDR) Enterobacterales. Currently, most of the data on MDR isolates focuses on Escherichia coli in uncomplicated urinary tract infection (uUTI). In 2020 Mecillinam uUTI-breakpoints were updated by EUCAST to include more species (now E. coli, Klebsiella spp., Citrobacter spp., Enterobacter spp., Raoultella spp., Proteus mirabilis). Mecillinam and temocillin have both been proposed for treatment of complicated urinary tract infection and step-down therapy in urosepsis. The aim of the present study was to compare the activity of mecillinam and temocillin in a diverse collection of MDR Enterobacterales.
Methods:The challenge collection comprised 402 isolates (E. coli (n=197), Klebsiella spp. (n=88), Enterobacter cloacae (n=55), Citrobacter freundii (n=32), Proteus mirabilis (n=10) and other Enterobacterales (n=20) collected from urine samples (n=385) or bloodcultures (n=17) between 2019 and 2020 at the university hospital of Cologne, Germany. Only Enterobacterales from clinical routine diagnostics with resistance to 3rd generation cephalosporines were included (MIC50 of cefotaxime >64mg/l). All isolates were characterized by ESBL and AmpC combination disk test, additionally by molecular assays in case of carbapenem-resistance. The following β–lactamases were detected: AmpC (N=135), ESBL (N=245), OXA-48 (n=10), VIM (n=2) and NDM (n=1), others (N=9). Susceptibility of temocillin and mecillinam were assessed by broth microdilution and agar dilution, respectively and MICs were compared to disk diffusion according to EUCAST.
Results:Until 02/2021 MIC testing has been completed for 298/404 isolates. For mecillinam MIC50/90 was 4/32 mg/L and for temocillin 4/16 mg/L. Stratified by beta-lactamases MIC50/90 of AmpC-producers was 2/128 mg/L for mecillinam and 8/32 mg/L for temocillin. In ESBL producers MIC50/90 was 2/16 mg/L for mecillinam and 4/16mg/L for temocillin. Some carbapenemase producing Enterobacterales (CPE) were susceptible to mecillinam (Citrobacter freundii (n=2) and Escherichia coli (n=2) with OXA-48), in contrast activity of temocillin was low in CPE (MIC50 ≥128).
Conclusions:Mecillinam and temocillin have promising In Vitro activity against MDR E. coli and non-E. coli isolates with ESBL-/AmpC beta-lactamases. Mecillinam has a higher activity in carbapenemase-producing Enterobacterales than temocillin.
Keyword(s): amdinocillin, ESBL, UTISession Type: ePosters
Session Title: ePosters
Authors(s): L. Plambeck (1), F. Fuchs (1), A. Hamprecht (1, 2, 3)
Authors Affiliations(s): (1) University of Cologne, Germany, (2) University of Oldenburg, Germany, (3) German Center for Infection research (DZIF), Germany
Background:
Mecillinam and temocillin are beta-lactam antibiotics which have been rediscovered because of their activity against multi-drug resistant (MDR) Enterobacterales. Currently, most of the data on MDR isolates focuses on Escherichia coli in uncomplicated urinary tract infection (uUTI). In 2020 Mecillinam uUTI-breakpoints were updated by EUCAST to include more species (now E. coli, Klebsiella spp., Citrobacter spp., Enterobacter spp., Raoultella spp., Proteus mirabilis). Mecillinam and temocillin have both been proposed for treatment of complicated urinary tract infection and step-down therapy in urosepsis. The aim of the present study was to compare the activity of mecillinam and temocillin in a diverse collection of MDR Enterobacterales.
Methods:The challenge collection comprised 402 isolates (E. coli (n=197), Klebsiella spp. (n=88), Enterobacter cloacae (n=55), Citrobacter freundii (n=32), Proteus mirabilis (n=10) and other Enterobacterales (n=20) collected from urine samples (n=385) or bloodcultures (n=17) between 2019 and 2020 at the university hospital of Cologne, Germany. Only Enterobacterales from clinical routine diagnostics with resistance to 3rd generation cephalosporines were included (MIC50 of cefotaxime >64mg/l). All isolates were characterized by ESBL and AmpC combination disk test, additionally by molecular assays in case of carbapenem-resistance. The following β–lactamases were detected: AmpC (N=135), ESBL (N=245), OXA-48 (n=10), VIM (n=2) and NDM (n=1), others (N=9). Susceptibility of temocillin and mecillinam were assessed by broth microdilution and agar dilution, respectively and MICs were compared to disk diffusion according to EUCAST.
Results:Until 02/2021 MIC testing has been completed for 298/404 isolates. For mecillinam MIC50/90 was 4/32 mg/L and for temocillin 4/16 mg/L. Stratified by beta-lactamases MIC50/90 of AmpC-producers was 2/128 mg/L for mecillinam and 8/32 mg/L for temocillin. In ESBL producers MIC50/90 was 2/16 mg/L for mecillinam and 4/16mg/L for temocillin. Some carbapenemase producing Enterobacterales (CPE) were susceptible to mecillinam (Citrobacter freundii (n=2) and Escherichia coli (n=2) with OXA-48), in contrast activity of temocillin was low in CPE (MIC50 ≥128).
Conclusions:Mecillinam and temocillin have promising In Vitro activity against MDR E. coli and non-E. coli isolates with ESBL-/AmpC beta-lactamases. Mecillinam has a higher activity in carbapenemase-producing Enterobacterales than temocillin.
Keyword(s): amdinocillin, ESBL, UTI
Session Type: ePosters
Session Title: ePosters
Authors(s): L. Plambeck (1), F. Fuchs (1), A. Hamprecht (1, 2, 3)
Authors Affiliations(s): (1) University of Cologne, Germany, (2) University of Oldenburg, Germany, (3) German Center for Infection research (DZIF), Germany
Background:
Mecillinam and temocillin are beta-lactam antibiotics which have been rediscovered because of their activity against multi-drug resistant (MDR) Enterobacterales. Currently, most of the data on MDR isolates focuses on Escherichia coli in uncomplicated urinary tract infection (uUTI). In 2020 Mecillinam uUTI-breakpoints were updated by EUCAST to include more species (now E. coli, Klebsiella spp., Citrobacter spp., Enterobacter spp., Raoultella spp., Proteus mirabilis). Mecillinam and temocillin have both been proposed for treatment of complicated urinary tract infection and step-down therapy in urosepsis. The aim of the present study was to compare the activity of mecillinam and temocillin in a diverse collection of MDR Enterobacterales.
Methods:The challenge collection comprised 402 isolates (E. coli (n=197), Klebsiella spp. (n=88), Enterobacter cloacae (n=55), Citrobacter freundii (n=32), Proteus mirabilis (n=10) and other Enterobacterales (n=20) collected from urine samples (n=385) or bloodcultures (n=17) between 2019 and 2020 at the university hospital of Cologne, Germany. Only Enterobacterales from clinical routine diagnostics with resistance to 3rd generation cephalosporines were included (MIC50 of cefotaxime >64mg/l). All isolates were characterized by ESBL and AmpC combination disk test, additionally by molecular assays in case of carbapenem-resistance. The following β–lactamases were detected: AmpC (N=135), ESBL (N=245), OXA-48 (n=10), VIM (n=2) and NDM (n=1), others (N=9). Susceptibility of temocillin and mecillinam were assessed by broth microdilution and agar dilution, respectively and MICs were compared to disk diffusion according to EUCAST.
Results:Until 02/2021 MIC testing has been completed for 298/404 isolates. For mecillinam MIC50/90 was 4/32 mg/L and for temocillin 4/16 mg/L. Stratified by beta-lactamases MIC50/90 of AmpC-producers was 2/128 mg/L for mecillinam and 8/32 mg/L for temocillin. In ESBL producers MIC50/90 was 2/16 mg/L for mecillinam and 4/16mg/L for temocillin. Some carbapenemase producing Enterobacterales (CPE) were susceptible to mecillinam (Citrobacter freundii (n=2) and Escherichia coli (n=2) with OXA-48), in contrast activity of temocillin was low in CPE (MIC50 ≥128).
Conclusions:Mecillinam and temocillin have promising In Vitro activity against MDR E. coli and non-E. coli isolates with ESBL-/AmpC beta-lactamases. Mecillinam has a higher activity in carbapenemase-producing Enterobacterales than temocillin.
Keyword(s): amdinocillin, ESBL, UTISession Type: ePosters
Session Title: ePosters
Authors(s): L. Plambeck (1), F. Fuchs (1), A. Hamprecht (1, 2, 3)
Authors Affiliations(s): (1) University of Cologne, Germany, (2) University of Oldenburg, Germany, (3) German Center for Infection research (DZIF), Germany
Background:
Mecillinam and temocillin are beta-lactam antibiotics which have been rediscovered because of their activity against multi-drug resistant (MDR) Enterobacterales. Currently, most of the data on MDR isolates focuses on Escherichia coli in uncomplicated urinary tract infection (uUTI). In 2020 Mecillinam uUTI-breakpoints were updated by EUCAST to include more species (now E. coli, Klebsiella spp., Citrobacter spp., Enterobacter spp., Raoultella spp., Proteus mirabilis). Mecillinam and temocillin have both been proposed for treatment of complicated urinary tract infection and step-down therapy in urosepsis. The aim of the present study was to compare the activity of mecillinam and temocillin in a diverse collection of MDR Enterobacterales.
Methods:The challenge collection comprised 402 isolates (E. coli (n=197), Klebsiella spp. (n=88), Enterobacter cloacae (n=55), Citrobacter freundii (n=32), Proteus mirabilis (n=10) and other Enterobacterales (n=20) collected from urine samples (n=385) or bloodcultures (n=17) between 2019 and 2020 at the university hospital of Cologne, Germany. Only Enterobacterales from clinical routine diagnostics with resistance to 3rd generation cephalosporines were included (MIC50 of cefotaxime >64mg/l). All isolates were characterized by ESBL and AmpC combination disk test, additionally by molecular assays in case of carbapenem-resistance. The following β–lactamases were detected: AmpC (N=135), ESBL (N=245), OXA-48 (n=10), VIM (n=2) and NDM (n=1), others (N=9). Susceptibility of temocillin and mecillinam were assessed by broth microdilution and agar dilution, respectively and MICs were compared to disk diffusion according to EUCAST.
Results:Until 02/2021 MIC testing has been completed for 298/404 isolates. For mecillinam MIC50/90 was 4/32 mg/L and for temocillin 4/16 mg/L. Stratified by beta-lactamases MIC50/90 of AmpC-producers was 2/128 mg/L for mecillinam and 8/32 mg/L for temocillin. In ESBL producers MIC50/90 was 2/16 mg/L for mecillinam and 4/16mg/L for temocillin. Some carbapenemase producing Enterobacterales (CPE) were susceptible to mecillinam (Citrobacter freundii (n=2) and Escherichia coli (n=2) with OXA-48), in contrast activity of temocillin was low in CPE (MIC50 ≥128).
Conclusions:Mecillinam and temocillin have promising In Vitro activity against MDR E. coli and non-E. coli isolates with ESBL-/AmpC beta-lactamases. Mecillinam has a higher activity in carbapenemase-producing Enterobacterales than temocillin.
Keyword(s): amdinocillin, ESBL, UTI