Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT.
Department of Pathology, Division of Clinical Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA.
Int J Antimicrob Agents. 2023 Mar;61(3):106733. doi: 10.1016/j.ijantimicag.2023.106733. Epub 2023 Jan 20.
Tebipenem is a potential option for the treatment of a range of infections because of its oral dosing coupled with the safety profile of the β-lactam antimicrobial class.
To evaluate tebipenem in vitro activity against a challenge set of clinical Enterobacterales collected from outpatient and community settings.
618 Enterobacterales isolates were submitted by 11 geographically dispersed U.S medical centers that processed cultures from affiliated outpatient centers in 2022. Susceptibility tests for tebipenem and comparator agents were performed by broth microdilution. Extended-spectrum-β-lactamase (ESBL)-like isolates were identified phenotypically. Multidrug-resistant isolates were non-susceptible to ≥1 agent in ≥3 antimicrobial classes. Genotypic testing (CarbaR) was conducted on select isolates.
Isolates (59% Escherichia coli) were recovered from patients seen predominantly in urology/nephrology (24%), nursing home/long-term care (21%), and ambulatory/primary care (21%) clinics. Comparator agent susceptibility rates against all isolates were as follows: levofloxacin (67.5%), amoxicillin/clavulanate (73.6%), cefixime (70.4%), cefpodoxime (70%), cephalexin (61.7%), ceftriaxone (74.4%), cefazolin (63.8%), ertapenem (97.6%), meropenem (99.7%), nitrofurantoin (64.9%), and sulfamethoxazole/trimethoprim (70.9%). Overall, 90.3% (558/619) of isolates were inhibited at a tebipenem MIC of ≤0.125 mg/L (MIC, 0.016/0.125 mg/L), including 85.7% inhibition of ESBL-phenotype isolates (n=161; MIC, 0.03/0.25 mg/L), 86.3% of levofloxacin and sulfamethoxazole/trimethoprim co-resistant isolates (n=95; MIC, 0.016/0.25 mg/L) and 84.3% of multidrug-resistant isolates (n = 172; MIC, 0.03/0.25 mg/L). Carbapenemase genes were observed in 2 ESBL-phenotype isolates with a tebipenem MIC of ≥0.5 mg/L.
Relative to common oral comparators, these data demonstrate excellent tebipenem in vitro activity against Enterobacterales isolated from patients receiving care in outpatient settings, including urology clinics and nursing homes.
替比培南由于其口服给药和β-内酰胺类抗菌药物的安全性，成为治疗多种感染的潜在选择。
评估替比培南对来自门诊和社区环境的一组挑战型临床肠杆菌科的体外活性。
2022 年，11 个地理位置分散的美国医疗中心提交了 618 株肠杆菌科分离株，这些中心从附属门诊中心处理培养物。替比培南和比较剂的药敏试验通过肉汤微量稀释法进行。表型鉴定为 ESBL 样分离株。多药耐药分离株对至少 3 种抗菌药物类别的≥1 种药物不敏感。对选定的分离株进行基因分型检测（CarbaR）。
分离株（59%为大肠杆菌）来自接受泌尿科/肾病学（24%）、疗养院/长期护理（21%）和门诊/初级保健（21%）诊所治疗的患者。所有分离株对比较剂的药敏率如下：左氧氟沙星（67.5%）、阿莫西林/克拉维酸（73.6%）、头孢克肟（70.4%）、头孢泊肟（70%）、头孢氨苄（61.7%）、头孢曲松（74.4%）、头孢唑林（63.8%）、厄他培南（97.6%）、美罗培南（99.7%）、呋喃妥因（64.9%）和磺胺甲噁唑/甲氧苄啶（70.9%）。总体而言，90.3%（558/619）的分离株对替比培南 MIC≤0.125mg/L 有抑制作用（MIC，0.016/0.125mg/L），包括对 ESBL 表型分离株的 85.7%抑制作用（n=161；MIC，0.03/0.25mg/L）、86.3%左氧氟沙星和磺胺甲噁唑/甲氧苄啶耐药分离株（n=95；MIC，0.016/0.25mg/L）和 84.3%多药耐药分离株（n=172；MIC，0.03/0.25mg/L）。在替比培南 MIC≥0.5mg/L 的 2 株 ESBL 表型分离株中观察到碳青霉烯酶基因。
与常用的口服比较剂相比，这些数据表明替比培南对来自接受门诊治疗的患者（包括泌尿科诊所和疗养院）的肠杆菌科分离株具有极好的体外活性。
