Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms

African Journal of Laboratory Medicine

Field Value
Title Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms
Creator Gupta, Shilpi Kumar, Mahadevan Shergill, Shelinder P.S. Tandel, Kundan
Subject Medicine; Microbiology ceftriaxone sulbactam, disodium edetate; multi-drug resistance; carbapenem-sparing
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.
Publisher AOSIS
Date 2020-12-10
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/ajlm.v9i1.991
Source African Journal of Laboratory Medicine; Vol 9, No 1 (2020); 6 pages 2225-2010 2225-2002
Language eng
Relation https://ajlmonline.org/index.php/ajlm/article/view/991/1783 https://ajlmonline.org/index.php/ajlm/article/view/991/1782 https://ajlmonline.org/index.php/ajlm/article/view/991/1784 https://ajlmonline.org/index.php/ajlm/article/view/991/1781
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Rights Copyright (c) 2020 Shilpi Gupta, Mahadevan Kumar, Shelinder P.S. Shergill, Kundan Tandel https://creativecommons.org/licenses/by/4.0