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Antimicrobial activity of imipenem against isolates from complicated urinary tract infections
Satoshi Ishihara1, Toru Yamada, Shigeaki Yokoi
1Department of Urology, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu 500-8705, Japan. s-ishi@cc.gifu-u.ac.jp
Abstract:
Antimicrobial activity of imipenem was measured using 4725 strains isolated from patients with complicated urinary tract infections (CUTIs) between 1988 and 2000. Imipenem was inactive against methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis, Enterococcus faecium and some non-fermenting Gram-negative rods. Resistant strains (MIC>16 mg/l) were observed in Staphylococcus haemolyticus (22%), Enterococcus faecalis (4%), Enterococcus avium (8%), Serratia marcescens (5%) and Pseudomonas aeruginosa (7%). Although the prevalence of imipenem-resistant strains of S. aureus, S. epidermidis and P. aeruginosa was sporadically high in some years, no steady increase was seen over the period. Resistant strains were rare in other major uropathogenic species. These results suggest that imipenem is still one of the most reliable antimicrobial drugs.
Insights
Imipenem remains a reliable antibiotic for complicated urinary tract infections (cUTIs). While resistance occurred in some bacteria like Staphylococcus and Pseudomonas aeruginosa, no overall increase was observed over 12 years.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Complicated urinary tract infections (cUTIs) pose a significant challenge due to evolving antimicrobial resistance.
- Carbapenem antibiotics, including imipenem, are crucial for treating severe bacterial infections.
- Monitoring the antimicrobial activity of imipenem is essential for guiding clinical practice.
Purpose of the Study:
- To evaluate the antimicrobial activity of imipenem against a large collection of bacterial strains.
- To assess the prevalence and trends of imipenem resistance in pathogens causing cUTIs over a 12-year period.
Main Methods:
- Antimicrobial susceptibility testing of imipenem was performed on 4725 bacterial isolates.
- Isolates were obtained from patients with cUTIs between 1988 and 2000.
- Minimum Inhibitory Concentrations (MICs) were determined to identify resistant strains (MIC > 16 mg/l).
Main Results:
- Imipenem showed inactivity against methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, and some non-fermenting Gram-negative rods.
- Resistant strains (MIC > 16 mg/l) were observed in Staphylococcus haemolyticus (22%), Enterococcus faecalis (4%), Enterococcus avium (8%), Serratia marcescens (5%), and Pseudomonas aeruginosa (7%).
- Sporadic high prevalence of resistance in S. aureus, S. epidermidis, and P. aeruginosa was noted in certain years, but no steady increase was detected over the study period.
Conclusions:
- Imipenem demonstrated sustained antimicrobial activity against most uropathogens causing cUTIs.
- Despite the presence of resistant strains, imipenem remains a highly reliable therapeutic option for cUTIs.
- Continued surveillance of antimicrobial resistance is vital for effective management of urinary tract infections.