JAC Advance Access originally published online on February 24, 2006
Journal of Antimicrobial Chemotherapy 2006 57(4):771-774; doi:10.1093/jac/dkl046
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In vitro activity of temocillin against extended spectrum ß-lactamase-producing Escherichia coli
Microbiology Department, Erasme Hospital–Université Libre de Bruxelles, Brussels, Belgium
Received 29 August 2005; returned 27 October 2005; revised 2 February 2006; accepted 2 February 2006
* Corresponding author. Tel: +32-2555-4518; Fax: +32-2555-3110; E-mail: hrodrigu{at}ulb.ac.be
Objectives: Temocillin is a semi-synthetic 6-
-methoxy derivative of ticarcillin. It is highly stable to most bacterial ß-lactamases. However, data concerning its activity against extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae are limited. We have analysed the in vitro activity of temocillin against clinical isolates of ESBL-producing Escherichia coli over the past 4 years in a university hospital in Brussels, Belgium.
Methods: Strains were screened for ESBL production using the double-disc synergy test. The MIC of 12 antimicrobial agents was determined for ESBL-producing E. coli isolates (n = 162) using the agar dilution method. ESBLs were characterized by isoelectric focusing; multiplex PCR for bla genes of the SHV, TEM and CTX-M families; and DNA sequencing.
Results: ESBL-producing E. coli isolates harboured CTX-M+TEM (35%), TEM alone (44%), CTX-M alone (6%), CTX-M+SHV (2%) and other ESBL combinations (10%). The proportion of temocillin-susceptible isolates was 92%, with MIC50 and MIC90 values of 8 and 32 mg/L, respectively. Co-resistance to ciprofloxacin and co-trimoxazole in ESBL-producing E. coli was frequent (39%). The proportion of isolates not susceptible to aminoglycosides was 55, 37 and 4% for tobramycin, gentamicin and amikacin, respectively. The proportion of isolates not susceptible to ceftazidime, cefotaxime, cefepime and piperacillin/tazobactam was 70, 52, 37 and 11%, respectively. No resistance to meropenem was observed. The proportion of strains exhibiting resistance to temocillin by year was stable over the study period.
Conclusions: These data indicate good in vitro activity of temocillin against multiresistant ESBL-producing E. coli. Prospective clinical studies are necessary to examine temocillin's potential role in the treatment of non-complicated infections caused by ESBL-producing E. coli.
Keywords: ESBLs , E. coli , antimicrobial susceptibility
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