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[The antimicrobial activity of cefteram against recently clinically detected and isolated strains]
Abstract:
In order to examine antibiotic activities of cefteram (CFTM), its minimum inhibitory concentrations (MIC's) and those of other cephem drugs were determined against clinically isolated strains received from July 1990 to June 1991 and from July 1992 to February 1993 from medical facilities throughout the country and against clinically isolated strains detected in our laboratory in samples from patients with various infectious diseases. The obtained results are summarized below. 1. No CFTM-resistant strains were found among beta-streptococci, Klebsiella spp., Proteus mirabilis, Haemophilus influenzae, and Neisseria gonorrhoeae or even when found, they were present in extremely low proportions. 2. It appeared that Streptococcus pneumoniae insensitive or resistant to beta-lactams, as well as cephems-resistant strains of Escherichia coli were increasing. The former included benzylpenicillin (PCG)-insensitive S. pneumoniae (PISP) of PCG-resistant S. pneumoniae (PRSP), and the presence of the latter suggests the possibility of the existence of "Extended broad-spectrum beta-lactamase" producing strains. The MIC's of beta-lactams against the above PISP or PRSP, and against cephems-resistant E. coli tended to be high, but those of CFTM were relatively low (in most cases). 3. Proportions of strains resistant to cephems, including CFTM among Citrobacter spp., Enterobacter spp., Serratia marcescens, Proteus vulgaris, Morganella morganii, and Providencia rettgeri were high, and in addition, the existence of these cephem resistant species suggests an increase in multiple drug resistant strains that show resistance to new quinolone drugs. 4. As mentioned above, CFTM is by no means a perfect drug or utility drug and its antimicrobial activities do not cover some recent isolates with multiple drug resistance. Except problems encountered with so-called "attenuated" strains of bacteria, increases in resistance can only be observed at a level of MIC90's, and as far as MIC80's are concerned, CFTM still is as active as before and may be used in the treatment of most infections we encounter in normal medical practices.
Insights
Cefteram (CFTM) shows good activity against many common bacteria, though resistance is increasing in some strains like Streptococcus pneumoniae and Escherichia coli. CFTM remains effective for most infections despite emerging multi-drug resistant bacteria.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Context:
- Antibiotic resistance is a growing global health concern, necessitating continuous evaluation of antimicrobial agents.
- Cephem antibiotics are crucial in treating bacterial infections, but their efficacy can be compromised by emerging resistance mechanisms.
- Clinical isolates from diverse geographical locations and time periods provide a representative sample for antimicrobial susceptibility testing.
Purpose:
- To evaluate the in vitro antibiotic activity of cefteram (CFTM) against clinically isolated bacterial strains.
- To compare the minimum inhibitory concentrations (MICs) of CFTM with other cephem drugs.
- To assess the susceptibility patterns of various bacterial species, including emerging resistant strains.
Summary:
- Cefteram (CFTM) demonstrated low minimum inhibitory concentrations (MICs) against beta-streptococci, Klebsiella spp., Proteus mirabilis, Haemophilus influenzae, and Neisseria gonorrhoeae.
- Increasing resistance was observed in Streptococcus pneumoniae (penicillin-insensitive and resistant strains) and Escherichia coli (cephem-resistant strains), potentially indicating extended-spectrum beta-lactamase production.
- High proportions of cephem-resistant strains, including CFTM-resistant isolates, were found in Citrobacter spp., Enterobacter spp., Serratia marcescens, Proteus vulgaris, Morganella morganii, and Providencia rettgeri, suggesting a rise in multi-drug resistant organisms.
Impact:
- CFTM maintains significant activity against many common bacterial pathogens, supporting its use in routine clinical practice for most infections.
- The study highlights the need for ongoing surveillance of antibiotic resistance, particularly for strains like Streptococcus pneumoniae and Escherichia coli.
- Emerging multi-drug resistance necessitates careful consideration of treatment options and may limit the utility of CFTM against certain resistant isolates.