Comparative in Vitro Activity of Temocillin, Meropenem, Ceftazidime, and Piperacillin/Tazobactam Against Panel Strains and Clini

ComparativeComparative inin vitrovitro activityactivity ofof Temocillin,Temocillin, Meropenem,Meropenem, Ceftazidime,Ceftazidime, andand Piperacillin/TazobactamPiperacillin/Tazobactam againstagainst panelpanel strainsstrains andand clinicalclinical isolatesisolates ofof BurkholderiaBurkholderia cepaciacepacia complexcomplex fromfrom 99 differentdifferent genomovarsgenomovars

S. Carryn1, P.M. Tulkens1, and P. Vandamme2 1Université catholique de Louvain, 2Universiteit Gent . cepacia ic group, 2002 t B bio i t An T penicillins CF TRUS K 2004; U

JCF infections treatment y,

Background - & Hoib aminoglycosides polymyxins anti-pseudomonal ring - - - ö Treatment of B. cepacia infections is hampered by their intrinsic resistance to many antimicrobial agents such as : Conventional therapy include combination of drugs active in vitro against the isolate with (when possible) different mechanisms of action D • • H 2 non- Me CO Me S S spp.) R H N OMe without S O H N H O 2 f B. cepacia CO o bacteria ESBL and AmpC Acinetobacter , emocillin S T to penicillins fections including n l i aeruginosa gram negative on rug for the treatment D only -lactamases nosocomia hypersensitivity β

: : ll a Orphan Pseudomonas ( irected tract infections d Background - ram negative rinary g u -methoxy-ticarcillin - - α active against producers Main Indications 6- spectrum fermenters Adverse Effects Recognized infection by the EMEA and FDA • • • • • • - t clinical β

f so

in vitro MIC few nel of laboratory strains a ts, only a n ailable

B. cepacia complex tients a 1992) with success for the treatment

JA Aim of the study sed in CF p u infections in CF patie azidime t

Bcc meropenem cef piperacillin/tazobactam temocillin Although temocillin has already been used in a pilo studies (Taylor, susceptibility data are av Our aim was, therefore, to determine the of lactams - - - - towards a well characterized p and clinical isolates of • • applied

P. aeruginosa al. (EJCM 1985) s et of Fuch

Pseudomonas were nia, vietnamensis, dolosa, ATCC 25923 and

E. coli g n udi Method and Strains were determined using the CLSI broth microdilution

B. multivorans B. cenocepacia B. cepacia, ambifria, pyrroci ATCC 27853 as quality control strains CLSI breakpoint for GNB non- for MER, CTZ, and PTZ; that fro temocillin for categorization 100 strains from 9 different species of Bcc were used with repartition between panel strains and clinical isolates 35 30 5 MICs technique incl stabilis, anthinia • • • > 128 > 128 128 128 64 64 32 32 IN 16 16 ml) ml) IDIME Z 8 8 A MIC (µg/ MIC (µg/ 4 4 TEMOCILL CEFT 2 2 1 1 0.5 0.5 0.25 0.25

5 0 5 0

s n i a r t s f o % s n i a r t s f 30 25 20 15 10 o % 30 25 20 15 10 > 128 IC distributions > 128 128 128 64 64 M M A CT 32 32 A 16 16 ZOB ml) ml) A 8 8 MIC (µg/ MIC (µg/ 4 ILLIN/T 4 C MEROPENEM A 2 2 PIPER 1 1 0.5 0.5 0.25

Results – 0.25

5 0

s n i a r t s f

5 0 o %

30 25 20 15 10 s n i a r t s f 30 25 20 15 o % 10 O TM Z PT Global Z CT

Susceptibility Results – R ME

10 20 30 40 50 60 70 80 90

s n i a r st e bl i suscept of % 77 30 43 60 77 30 43 60 (n = 30) (n = 30) cenocepacia cenocepacia

B. B.

Results 68 51 77 46 68 51 77 46 (n = 35) multivorans multivorans (n = 35)

B. B.

Comparison between species TMO PTZ CTZ MER TMO PTZ CTZ MER % of susceptible strains (7) (6) (5) (1) (1) pecies cenocepacia cepacia cenocepacia multivorans vietnamensis multivorans dolosa S

B. multivorans B. B. B. B. B. B. B. 1 7 3 1 of strains 13

articular Strains br P n

o only t TMO CTZ MER PTZ Results – susceptible Strains resistant to all antibiotics 8 2 > 1 8 12 64 32 ) 16 ml / Z g µ 8 ( PT C ates (n = 55) l MI 4 2 al iso 1 ic 5 0. Clin 25 0.

5 0

35 30 25 20 15 10

s n i a r t s f o % 128 >

Results 128 64 32 ) 16 ml / Z g µ 8 ( CT

vs. Clinical Isolates C MI 4 2

Comparison : Panel Strains 1 Panel strains (n = 45) 5 0. 5 2 0.

5 0

35 30 25 20 15 10

s in a r t s f o % 128 > 128 64 32 ) l 16 m / O g µ 8 ( TM C ates (n = 55) l MI 4 2 al iso 1 ic 5 0. Clin 5 2 0.

5 0

35 30 25 20 15 10

s in a r t s f o % 8 2 > 1 8

Results 12 64 32 ) 16 ml / R g µ 8 ( ME

vs. Clinical Isolates C MI 4 2

Comparison : Panel Strains 1 Panel strains (n = 45) 5 0. 5 2 0.

5 0

35 30 25 20 15 10

s in a r t s f o % B.

B. cenocepacia -lactam tested and β e of temocillin in those of the pilot study erspectives ntag

P a v

B. cepacia

B. multivorans tential ad o infected CF patients

These results combined with suggest a p cepacia Conclusions - here was no significant differences between panel Temocillin was the most active against these strains of There might be a slightly different susceptibility pattern between (especially for ceftazidime). T strains and clinical isolates • • •