JAC Advance Access published online on April 29, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh218
© 2004 by The British Society for Antimicrobial Chemotherapy
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1 Department of Microbiology,
Hospital de Móstoles, 28935 Móstoles, Madrid;
* To whom correspondence should be addressed. E-mail: nachoalos{at}microb.net.
Background: The treatment of complicated
urinary tract infections may require the use of a parenteral antibiotic
with potent activity against the most common urinary pathogens.
Ertapenem is a broad-spectrum 1 Methods: The purpose of this work was to test
the in vitro susceptibility to ertapenem, ampicillin,
cefazolin, cefuroxime, cefotaxime, co-amoxiclav, piperacillin/tazobactam,
imipenem, gentamicin, amikacin, fosfomycin, ciprofloxacin and co-trimoxazole
of 482 strains of urinary pathogens of the family Enterobacteriaceae isolated
from patients in the community of Madrid (40% from males).
The distribution was as follows: Escherichia coli (n = 315), Proteus mirabilis (n = 42), Klebsiella spp. (n = 14) and AmpC-producing
Enterobacteriaceae (n = 111). The strains
studied were selected based on their resistance to quinolones and aminoglycosides,
and their production of extended-spectrum Results: All the strains were susceptible to
ertapenem, imipenem and amikacin. The MIC90 of ertapenem ranged
from a minimum of 0.03 mg/L for Proteus vulgaris and
a maximum of 1 mg/L for Enterobacter spp. Ertapenem
was the most active of all drugs tested in all cases. On comparing
antibiotic resistance among ESBL-producing strains of E.
coli (n = 35) and E.
coli strains not producing ESBLs (n = 280),
statistically significant differences were obtained for ciprofloxacin
(P = 0.002) and gentamicin (P = 0.011).
Regarding ertapenem, only a slight increase in MIC50 was
seen, the value being 0.015 mg/L for strains not producing ESBLs
versus 0.03 mg/L for ESBL-producing strains. Conclusions: In view of its significant antibiotic
potency against antibiotic-resistant Enterobacteriaceae, ertapenem
may constitute a good therapeutic alternative in urinary infections
caused by these pathogens.
Revised March 1, 2004
Accepted March 1, 2004
Brief report
In vitro susceptibility of recent
antibiotic-resistant urinary pathogens to ertapenem and 12 other
antibiotics
2 Department of Microbiology, Hospital
Universitario Príncipe de Asturias, Alcalá de
Henares, Madrid;
3 Department
of Microbiology,
Hospital Universitario de Getafe, Getafe, Madrid, Spain
Abstract 
-methyl
carbapenem with a long plasma half-life that allows administration
of a single daily dose.-lactamases
(ESBLs) or AmpC-type -lactamases.
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