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Imipenem/relebactam activity compared to other antimicrobials against non-MBL-producing carbapenem-resistant Enterobacteriaceae from an academic medical center.
Pathog Dis. 2019 06 01; 77(4)PD

Abstract

BACKGROUND

Carbapenem-resistant Enterobacteriaceae (CRE) cause significant mortality and are resistant to most antimicrobial agents. Imipenem/relebactam, a novel beta-lactam/beta-lactamase inhibitor combination, and 16 other antimicrobials were evaluated against non-metallo-beta-lactamase-producing carbapenem-resistant Enterobacteriaceae clinical isolates from a United States tertiary academic medical center.

OBJECTIVES

To evaluate imipenem/relebactam and other commonly utilised antimicrobial agents against carbapenem-resistant Enterobacteriaceae.

METHODS

Clinical isolates (n = 96) resistant to ertapenem or meropenem by BD Phoenix (Becton, Dickinson and Company, Franklin Lakes, NJ, USA) and negative for metallo-beta-lactamase-production by an EDTA (Sigma-Aldrich Corp., St. Louis, MO, USA)/phenylboronic acid (Sigma-Aldrich Corp., St. Louis, MO, USA) disk diffusion assay were identified and collected from January 2012 to January 2017. In vitro susceptibility by broth microdilution was performed according to CLSI guidelines using CLSI susceptibility breakpoints for 17 antimicrobials (Sigma-Aldrich Corp., St. Louis, MO, USA).

RESULTS

CRE primarily produced Klebsiella pneumoniae carbapenemase (KPC) and consisted primarily of K. pneumoniae (55%) and Enterobacter spp. (25%), followed by Citrobacter spp. (10%), Escherichia coli (5%), and others (5%). CRE were most susceptible to imipenem/relebactam (100%), followed by amikacin (85%), tigecycline (82%), and polymyxin B/colistin (65%). The median reduction of imipenem minimum inhibitory concentrations (MICs) of non-MBL-producing CRE was 16-fold but ranged from 0.5 to >512-fold. The MIC50, MIC90 and MIC range of imipenem/relebactam was 0.5/4, 1/4 and 0.06/4-1/4 mg/L, respectively.

CONCLUSIONS

Imipenem/relebactam exhibits excellent activity against CRE that produce KPC.

Authors+Show Affiliations

Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington 40536, KY, USA.Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington 40536, KY, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31365075

Citation

Kulengowski, Brandon, and David S. Burgess. "Imipenem/relebactam Activity Compared to Other Antimicrobials Against non-MBL-producing Carbapenem-resistant Enterobacteriaceae From an Academic Medical Center." Pathogens and Disease, vol. 77, no. 4, 2019.
Kulengowski B, Burgess DS. Imipenem/relebactam activity compared to other antimicrobials against non-MBL-producing carbapenem-resistant Enterobacteriaceae from an academic medical center. Pathog Dis. 2019;77(4).
Kulengowski, B., & Burgess, D. S. (2019). Imipenem/relebactam activity compared to other antimicrobials against non-MBL-producing carbapenem-resistant Enterobacteriaceae from an academic medical center. Pathogens and Disease, 77(4). https://doi.org/10.1093/femspd/ftz040
Kulengowski B, Burgess DS. Imipenem/relebactam Activity Compared to Other Antimicrobials Against non-MBL-producing Carbapenem-resistant Enterobacteriaceae From an Academic Medical Center. Pathog Dis. 2019 06 1;77(4) PubMed PMID: 31365075.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Imipenem/relebactam activity compared to other antimicrobials against non-MBL-producing carbapenem-resistant Enterobacteriaceae from an academic medical center. AU - Kulengowski,Brandon, AU - Burgess,David S, PY - 2019/03/26/received PY - 2019/07/30/accepted PY - 2019/8/1/pubmed PY - 2020/3/28/medline PY - 2019/8/1/entrez KW - KPC KW - MBL KW - antimicrobial susceptibility testing KW - carbapenem-resistant Enterobacteriaceae KW - imipenem/relebactam JF - Pathogens and disease JO - Pathog Dis VL - 77 IS - 4 N2 - BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) cause significant mortality and are resistant to most antimicrobial agents. Imipenem/relebactam, a novel beta-lactam/beta-lactamase inhibitor combination, and 16 other antimicrobials were evaluated against non-metallo-beta-lactamase-producing carbapenem-resistant Enterobacteriaceae clinical isolates from a United States tertiary academic medical center. OBJECTIVES: To evaluate imipenem/relebactam and other commonly utilised antimicrobial agents against carbapenem-resistant Enterobacteriaceae. METHODS: Clinical isolates (n = 96) resistant to ertapenem or meropenem by BD Phoenix (Becton, Dickinson and Company, Franklin Lakes, NJ, USA) and negative for metallo-beta-lactamase-production by an EDTA (Sigma-Aldrich Corp., St. Louis, MO, USA)/phenylboronic acid (Sigma-Aldrich Corp., St. Louis, MO, USA) disk diffusion assay were identified and collected from January 2012 to January 2017. In vitro susceptibility by broth microdilution was performed according to CLSI guidelines using CLSI susceptibility breakpoints for 17 antimicrobials (Sigma-Aldrich Corp., St. Louis, MO, USA). RESULTS: CRE primarily produced Klebsiella pneumoniae carbapenemase (KPC) and consisted primarily of K. pneumoniae (55%) and Enterobacter spp. (25%), followed by Citrobacter spp. (10%), Escherichia coli (5%), and others (5%). CRE were most susceptible to imipenem/relebactam (100%), followed by amikacin (85%), tigecycline (82%), and polymyxin B/colistin (65%). The median reduction of imipenem minimum inhibitory concentrations (MICs) of non-MBL-producing CRE was 16-fold but ranged from 0.5 to >512-fold. The MIC50, MIC90 and MIC range of imipenem/relebactam was 0.5/4, 1/4 and 0.06/4-1/4 mg/L, respectively. CONCLUSIONS: Imipenem/relebactam exhibits excellent activity against CRE that produce KPC. SN - 2049-632X UR - https://www.unboundmedicine.com/medline/citation/31365075/Imipenem/relebactam_activity_compared_to_other_antimicrobials_against_non_MBL_producing_carbapenem_resistant_Enterobacteriaceae_from_an_academic_medical_center_ L2 - https://academic.oup.com/femspd/article-lookup/doi/10.1093/femspd/ftz040 DB - PRIME DP - Unbound Medicine ER -