Kaleem Fatima, Aftab Irum, Farwa Umme, Saleem Hassan, Ishtiaq Saima, Syed Saima, Abbasi Shahid Ahmad
Department of Pathology, Foundation University Medical College, FUI, Islamabad, Pakistan.
Department of Surgery, Quaid I Azam International Hospital, Islamabad, Pakistan.
Iran J Microbiol. 2022 Oct;14(5):662-668. doi: 10.18502/ijm.v14i5.10959.
This study was designed to determine the efficacy of mecillinam against extended spectrum beta lactamse producing Enterobacterales.
After proper permission from Ethical Review Committee of the Institute, all samples yielding growth of ESBL producing Enterobacterales were part of the study and were processed according to routine microbiological procedures. Routine antibiotic sensitivity testing was done on Muller Hinton Agar by Modified Kirby Bauer Method. All Gram negative isolates were subjected to concomitant detection of ESBL production by double disc synergy method. All ESBL producers were then subjected to the mecillinam Minimum Inhibitory Concentration (MIC) determination by E test. The results were interpreted as per CLSI Guidelines.
A total of 120 ESBL producing Enterobacterales isolates were included in the study. The mean age of patients with ESBL infection was 45 ± 18.7 years. There were 44% male and 55% female patients. Majority of the ESBL producing Enterobacterales were isolated from urine samples (56%), followed by pus. Among the isolated organisms, (45%) was the most frequently isolated organism followed by spp. (22%). Overall 83% of the isolates turned out to be sensitive to mecillinam. MIC50 of mecillinam against ESBL producing Gram negative rods (GNR) turned out to be 1 ug/ml and MIC90 turned out to be 2 ug/ml.
Mecillinam shows good efficacy against ESBL producing Enterobacterales in our study. Further studies with more sample size and from diverse areas across the country should be done to evaluate its efficacy.
本研究旨在确定美西林对产超广谱β-内酰胺酶肠杆菌科细菌的疗效。
经研究所伦理审查委员会适当批准后，所有培养出产超广谱β-内酰胺酶肠杆菌科细菌的样本均纳入本研究，并按照常规微生物学程序进行处理。采用改良 Kirby Bauer 法在 Muller Hinton 琼脂上进行常规抗生素敏感性试验。所有革兰氏阴性分离株均采用双纸片协同法同时检测超广谱β-内酰胺酶的产生情况。然后，所有产超广谱β-内酰胺酶菌株采用 E 试验测定美西林的最低抑菌浓度（MIC）。结果按照 CLSI 指南进行解读。
本研究共纳入 120 株产超广谱β-内酰胺酶肠杆菌科细菌分离株。产超广谱β-内酰胺酶感染患者的平均年龄为 45±18.7 岁。男性患者占 44%，女性患者占 55%。大多数产超广谱β-内酰胺酶肠杆菌科细菌分离自尿液样本（56%），其次是脓液。在分离出的微生物中，（45%）是最常分离出的微生物，其次是 spp.（22%）。总体而言，83%的分离株对美西林敏感。美西林对产超广谱β-内酰胺酶革兰氏阴性杆菌（GNR）的 MIC50 为 1μg/ml，MIC90 为 2μg/ml。
在我们的研究中，美西林对产超广谱β-内酰胺酶肠杆菌科细菌显示出良好的疗效。应进行更多样本量且来自全国不同地区的进一步研究，以评估其疗效。
