In vitro activities of ertapenem (MK-0826) against recent clinical bacteria collected in Europe and Australia

Citation
Dm. Livermore et al., In vitro activities of ertapenem (MK-0826) against recent clinical bacteria collected in Europe and Australia, ANTIM AG CH, 45(6), 2001, pp. 1860-1867
Citations number
24
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Microbiology
Journal title
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
ISSN journal
0066-4804 → ACNP
Volume
45
Issue
6
Year of publication
2001
Pages
1860 - 1867
Database
ISI
SICI code
0066-4804(200106)45:6<1860:IVAOE(>2.0.ZU;2-C
Abstract
Ertapenem (MK-0826, L-749,345) is a l-beta -methyl carbapenem with a long s erum half-life. Its in vitro activity was determined by broth microdilution against 3,478 bacteria from 12 centers in Europe and Australia, with imipe nem, cefepime, ceftriaxone, and piperacillin-tazobactam used as comparators . Ertapenem was the most active agent tested against members of the family Enterobacteriaceae, with MICs at which 90% of isolates are inhibited (MIC(9 0)s) of less than or equal to1 mug/ml for all species. Ertapenem also was m ore active than imipenem against fastidious gram-negative bacteria and Mora xella spp.; on the other hand, ertapenem was slightly less active than imip enem against streptococci, methicillin-susceptible staphylococci, and anaer obes, but its MIC(90)s for these groups remained less than or equal to0.5 m ug/ml. Acinetobacter spp. and Pseudomonas aeruginosa. were also much less s usceptible to ertapenem than imipenem, and most Enterococcus faecalis strai ns were resistant. Ertapenem resistance, based an a provisional NCCLS MIC b reakpoint of greater than or equal to 16 mug/ml, was seen in only 3 of 1,61 1 strains of the family Enterobacteriaceae tested, all of them Enterobacter aerogenes. Resistance was also seen in 2 of 135 anaerobes, comprising I Ba cteroides fragilis strain and 1 Clostridium difficile strain. Ertapenem bre akpoints for streptococci have not been established, but an unofficial susc eptibility breakpoint of less than or equal to2 mug/ml was adopted for clin ical trials to generate corresponding clinical response data for isolates f or which MICs were as high as 2 mug/ml, Of 234 Streptococcus pneumoniae str ains tested, 2 required ertapenem MICs of 2 mug/ml and one required an MIC of 4 mug/ml, among 67 non-Streptococcus pyogenes, non-Streptococcus pneumon iae streptococci, single isolates required ertapenem MICs of 2 and 16 mug/m l. These streptococci also had diminished susceptibilities to other p-lacta ms, including imipenem as well as ertapenem. The Etest and disk diffusion g ave susceptibility test results in good agreement with those of the broth m icrodilution method for ertapenem.