Summary
Strains ofEscherichia coli (N=124) andProteus mirabilis (N=29) harboring known β-lactamases were analyzed as to their susceptibility to ampicillin, amoxicillin, and piperacillin alone and in combination with sulbactam, clavulanate, and tazobactam. With TEM 1-producingE. coli, a correlation between specific β-lactamase activity and the MIC of piperacillin and ampicillin-sulbactam was observed. These strains also showed significant differences in susceptibilities to the various combinations, suggesting that, at least in strains resistant to one combination, several β-lactam/β-lactamase inhibitor combinations should be tested in the laboratory. All combinations tested enhanced the activity of the β-lactam towards TEM 1-producingE. coli, piperacillin-tazobactam being the most active. The drugs were less active to OXA 1 enzymes; solely with piperacillin-tazobactam 90% of strains were within the therapeutic range of the drug. Sulbactam acted synergistically to chromosomally encoded β-lactamases, whereas amoxicillin-clavulanate was inactive. Piperacillin and piperacillin-tazobactam inhibited all strains producing chromosomally encoded β-lactamases at concentrations within the therapeutic range of the drugs. In contrast, TEM 2 ofP. mirabilis was not sensitive to ampicillin-sulbactam, but to the other combinations; here again piperacillin-tazobactam was the most active.
Zusammenfassung
Wir untersuchten die Empfindlichkeit vonEscherichia coli (N=124) undProteus mirabilis-Stämmen (N=29) mit bekannten β-Laktamasen gegenüber Ampicillin, Amoxicillin und Piperacillin, allein und in Kombination mit Sulbactam, Clavulansäure oder Tazobactam. Bei TEM 1-produzierendenE. coli-Stämmen fanden wir eine Korrelation zwischen der spezifischen β-Laktamase-Aktivität und der MHK gegenüber Piperacillin oder Ampicillin-Sulbactam. Diese Stämme zeigten auch erhebliche Unterschiede in der Empfindlichkeit gegenüber den untersuchten Kombinationen. Daher ist zu empfehlen, wenigstens bei Stämmen, die gegenüber einer Kombination resistent sind, mehrere β-Laktamase-Inhibitor-Kombinationen zu untersuchen. Alle eingesetzten Kombinationen zeigten Synergismus gegen TEM 1-produzierendeE.-coli-Stämme, dabei war Piperacillin-Tazobactam am aktivsten. Gegenüber OXA 1-β-Laktamasen waren alle Kombinationen weniger wirksam. Nur Sulbactam in der Kombination mit Ampicillin zeigte Synergismus gegen chromosomal kodierte Enzyme, Amoxicillin-Clavulansäure war nicht aktiv. Piperacillin und Piperacillin-Tazobactam waren wirksam gegenüber allen Stämmen mit chromosomal kodierten β-Laktamasen, dabei lagen die minimalen Hemmkonzentrationen im therapeutisch nutzbaren Bereich. Demgegenüber war Ampicillin-Sulbactam inaktiv gegen TEM 2-produzierendeP. mirabilis-Stämme, die anderen Kombinationen waren wirksam, dabei zeigte Piperacillin-Tazobactam die höchste Aktivität.
Similar content being viewed by others
References
Fass, R. J., Prior, R. B. Comparativein vitro activities of piperacillin-tazobactam and ticarcillin-clavulanate. Antimicrob. Agents Chemother. 33 (1989) 1268–1274.
Jacobs, M. R., Aronoff, S. C., Johenning, S., Shlaes, D. M., Yamanabe, S. Comparative activities of the β-lactamase inhibitors YTR830, clavulanate, and sulbactam combined with ampicillin and broad-spectrum penicillins against defined β-lactamase-producing aerobic gram-negative bacilli. Antimicrob. Agents Chemother. 29 (1986) 980–985.
Gutmann, L., Kitzis, M. D., Yamabe, S., Acar, J. F. Comparative evaluation of a new β-lactamase inhibitor, YTR830, combined with different β-lactam antibiotics against bacteria harboring known β-lactamases. Antimicrob. Agents Chemother. 29 (1986) 955–957.
Marre, R., Aleksic, S. Beta-lactamase types and beta-lactam resistance ofEscherichia coli strains with chromosomally-mediated ampicillin resistance. Eur. J. Clin. Microbiol. Inf. Dis. 1 (1990) 44–46.
Marre, R., Borner, K., Schulz, E. Different mechanisms of TEM-1 and Oxa-1 mediated resistance to piperacillin inE. coli. Zentralbl. Bakteriol. Hyg. A 258 (1984) 287–295.
Higashitani, F., Hyodo, A., Ishida, N., Inoue, M., Mitsuhashi, S. Inhibition of β-lactamases by tazobactam andin-vitro antibacterial activity of tazobactam combined with piperacillin. J. Antimicrob. Chemother. 25 (1990) 567–574.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gatermann, S., Marre, R. Comparative in vitro activities of amoxicillin-clavulanate, ampicillin-sulbactam and piperacillin-tazobactam against strains of escherichia coli and proteus mirabilis harbouring known β-lactamases. Infection 19, 106–109 (1991). https://doi.org/10.1007/BF01645578
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01645578