Infectious Diseases Department, Rouen University Hospital, Rouen, France.
EA 2656 (Groupe de Recherche sur l'Adaptation Microbienne 2.0), Institute for Research and Innovation in Biomedicine, Normandie Univ, Unirouen, Rouen, France.
J Antimicrob Chemother. 2018 Jul 1;73(7):1848-1853. doi: 10.1093/jac/dky101.
Temocillin is an old 'revived' antibiotic that may play an important role in the treatment of febrile urinary tract infection (UTI). Data regarding its activity against current Enterobacteriaceae isolates as well as the performance of routine susceptibility testing methods are, however, scarce.
To determine the MICs of temocillin for Enterobacteriaceae strains reflecting the current epidemiology and to analyse the accuracy of three commercial methods.
Enterobacteriaceae isolates causing community-acquired UTI were prospectively collected from September 2015 to January 2017 in two French centres. Temocillin MIC was determined by agar dilution (AD) as the reference method and then compared with: (i) susceptibility testing by disc diffusion; (ii) MIC determination by Etest; and (iii) MIC estimation by the Vitek 2 automated system.
A total of 762 Enterobacteriaceae were analysed comprising 658 (86.4%) Escherichia coli and 37 (4.9%) ESBL-producing isolates. Susceptibility rate assessed by AD was 99.6% according to the 8 mg/L clinical breakpoint and was significantly lower against the ESBL-producing isolates than the non-ESBL-producing isolates (94.6% versus 99.9%, P < 0.01). The MIC50 and MIC90 for the total set were 3 and 6 mg/L, respectively. According to the 8 mg/L clinical breakpoint, the major error rate was <1% for disc diffusion and Etest, and significantly higher for Vitek 2 (4.3%, P < 0.01), but still low. No very major error was noticed.
Temocillin showed a high level of activity against Enterobacteriaceae from community-acquired UTI and good to excellent reliability of routine methods for susceptibility testing in such a setting.
替莫西林是一种古老的“复兴”抗生素，在治疗发热性尿路感染（UTI）方面可能发挥重要作用。然而，有关其对当前肠杆菌科分离株的活性以及常规药敏检测方法表现的数据却很少。
确定反映当前流行病学的替莫西林对肠杆菌科菌株的 MIC 值，并分析三种商业方法的准确性。
2015 年 9 月至 2017 年 1 月，在法国的两个中心前瞻性收集社区获得性 UTI 引起的肠杆菌科分离株。琼脂稀释法（AD）作为参考方法测定替莫西林 MIC，然后与以下方法进行比较：（i）纸片扩散法药敏试验；（ii）Etest MIC 测定；（iii）Vitek 2 自动化系统 MIC 估计。
共分析了 762 株肠杆菌科，其中 658 株（86.4%）为大肠埃希菌和 37 株（4.9%）ESBL 产酶株。AD 测定的药敏率根据 8mg/L 临床折点为 99.6%，对 ESBL 产酶株的药敏率显著低于非 ESBL 产酶株（94.6%对 99.9%，P<0.01）。总集合的 MIC50 和 MIC90 分别为 3mg/L 和 6mg/L。根据 8mg/L 临床折点，纸片扩散法和 Etest 的主要错误率<1%，Vitek 2 显著更高（4.3%，P<0.01），但仍较低。未发现非常大的错误。
替莫西林对社区获得性 UTI 的肠杆菌科具有很高的活性，并且在这种情况下常规药敏检测方法的可靠性良好至极好。
