Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms
Background: Multi-drug resistant (MDR) Gram-negative bacteria are an emerging threat, both in hospital and community settings. As very few antibiotics are effective against such infections, the need of the hour is a new antibiotic or drug combination which can overcome the effect of extended-spectru...
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doaj-a07ebbbd1deb47c89fea2337582b77492020-12-11T13:51:00ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102020-12-0191e1e610.4102/ajlm.v9i1.991296Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organismsShilpi Gupta0Mahadevan Kumar1Shelinder P.S. Shergill2Kundan Tandel3Department of Microbiology, Military Hospital, BhopalDepartment of Microbiology, Bharati Vidyapeeth University Medical College, PuneDepartment of Microbiology, Armed Forces Medical College, PuneDepartment of Microbiology, Command Hospital (Central Command), LucknowBackground: Multi-drug resistant (MDR) Gram-negative bacteria are an emerging threat, both in hospital and community settings. As very few antibiotics are effective against such infections, the need of the hour is a new antibiotic or drug combination which can overcome the effect of extended-spectrum β-lactamases (ESBL) and metallo β-lactamases (MBL). A new antibiotic combination of ceftriaxone, sulbactam and disodium edetate (CSE) has recently been proposed to tackle the MDR organisms. Objective: Our study was carried out to assess the susceptibility of ESBL- and MBL-producing Gram-negative organisms to CSE. Methods: The study was conducted in a tertiary-care hospital in Delhi, India, from February 2017 to June 2017. A total of 179 MDR (85 ESBL + 94 MBL) Gram-negative isolates from various clinical samples, identified by an automated system (Vitek 2) were tested against CSE using the Kirby-Bauer disc diffusion method. Susceptibility to CSE was recorded based on interpretative zone sizes of ceftriaxone as per 2017 Clinical and Laboratory Standards Institute guidelines. Results: The most common isolate was Escherichia coli (76/179; 42.4%) followed by Klebsiella pneumoniae (53/179; 29.6%) and Acinetobacter baumanii (27/179; 15.1%). The in vitro susceptibility of ESBL- and MBL-producing Gram-negative isolates to CSE was found to be 58/85 (68.2%) for ESBL and 37/94 (39.4%) for MBL. Conclusion: The in vitro susceptibility results obtained for CSE against ESBL-producing organisms is promising. It has the potential to emerge as a carbapenem-sparing antibiotic, active against ESBL-producing strains. Further clinical studies are required to establish the clinical efficacy of CSE against MDR pathogens.https://ajlmonline.org/index.php/ajlm/article/view/991ceftriaxone sulbactam, disodium edetatemulti-drug resistancecarbapenem-sparing |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shilpi Gupta Mahadevan Kumar Shelinder P.S. Shergill Kundan Tandel |
spellingShingle |
Shilpi Gupta Mahadevan Kumar Shelinder P.S. Shergill Kundan Tandel Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms African Journal of Laboratory Medicine ceftriaxone sulbactam, disodium edetate multi-drug resistance carbapenem-sparing |
author_facet |
Shilpi Gupta Mahadevan Kumar Shelinder P.S. Shergill Kundan Tandel |
author_sort |
Shilpi Gupta |
title |
Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms |
title_short |
Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms |
title_full |
Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms |
title_fullStr |
Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms |
title_full_unstemmed |
Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms |
title_sort |
evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant gram-negative organisms |
publisher |
AOSIS |
series |
African Journal of Laboratory Medicine |
issn |
2225-2002 2225-2010 |
publishDate |
2020-12-01 |
description |
Background: Multi-drug resistant (MDR) Gram-negative bacteria are an emerging threat, both in hospital and community settings. As very few antibiotics are effective against such infections, the need of the hour is a new antibiotic or drug combination which can overcome the effect of extended-spectrum β-lactamases (ESBL) and metallo β-lactamases (MBL). A new antibiotic combination of ceftriaxone, sulbactam and disodium edetate (CSE) has recently been proposed to tackle the MDR organisms.
Objective: Our study was carried out to assess the susceptibility of ESBL- and MBL-producing Gram-negative organisms to CSE.
Methods: The study was conducted in a tertiary-care hospital in Delhi, India, from February 2017 to June 2017. A total of 179 MDR (85 ESBL + 94 MBL) Gram-negative isolates from various clinical samples, identified by an automated system (Vitek 2) were tested against CSE using the Kirby-Bauer disc diffusion method. Susceptibility to CSE was recorded based on interpretative zone sizes of ceftriaxone as per 2017 Clinical and Laboratory Standards Institute guidelines.
Results: The most common isolate was Escherichia coli (76/179; 42.4%) followed by Klebsiella pneumoniae (53/179; 29.6%) and Acinetobacter baumanii (27/179; 15.1%). The in vitro susceptibility of ESBL- and MBL-producing Gram-negative isolates to CSE was found to be 58/85 (68.2%) for ESBL and 37/94 (39.4%) for MBL.
Conclusion: The in vitro susceptibility results obtained for CSE against ESBL-producing organisms is promising. It has the potential to emerge as a carbapenem-sparing antibiotic, active against ESBL-producing strains. Further clinical studies are required to establish the clinical efficacy of CSE against MDR pathogens. |
topic |
ceftriaxone sulbactam, disodium edetate multi-drug resistance carbapenem-sparing |
url |
https://ajlmonline.org/index.php/ajlm/article/view/991 |
work_keys_str_mv |
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