SUSCEPTIBILITY OF E COLI TO AMOXICILLIN/CLAVULANATE AND AMPICILLIN/SULBACTAM

大肠杆菌对阿莫西林/克拉维酸和氨苄西林/舒巴坦的敏感性

• 批准号: 2456714
• 负责人: E O'SHAUGHNESSY
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/2456714
• 关键词: Escherichia coli; ampicillin; beta lactamase; drug screening /evaluation; enzyme inhibitors; genetic strain; microorganism culture; penicillins

This project's principal focus has been to investigate the in vitro susceptibility of ampicillin-resistant Escherichia coli to amoxicillin/clavulanate and ampicillin/sulbactam. These two antibiotic-beta lactamase inhibitor combinations have been stated to be comparable in their clinical efficacy and therefore should be comparable in their in vitro susceptibility results. A lack of correlation of routine susceptibility test results between these two agents was noted in clinical isolates of ampicillin-resistant E. coli from National Institutes of Health patients. The reproducibility of the results was assessed by repeating the sensitivity test procedure on the isolates and the validity was further investigated by performing susceptibility testing by other methods. Susceptibility results of 182 ampicillin-resistant isolates revealed that amoxicillin/ clavulanate and ampicillin/sulbactam had a low degree of correlation by the initial microdilution susceptibility testing procedure. This discrepancy was confirmed by retesting representative isolates, and the validity of the discrepancy was confirmed by another susceptibility test procedure. Of the isolates, 75.3 percent were amoxicillin/clavulanate sensitive and ampicillin/sulbactam intermediate or resistant. Plasmid fingerprinting was performed to demonstrate that the E. coli isolates represented different strains; therefore, the discrepant results were not limited to one or a few unusual E. coli isolates. Given the results of clinical trials that suggest the in vivo equivalence of both agents, it seems probable that the discrepancies observed are a consequence of inappropriate break points established by the National Committee for Clinical Laboratory Standards. The assessment of all ampicillin-resistant E. coli isolated during a 1- year period is in progress.

该项目的主要重点是研究体外 耐氨苄青霉素大肠杆菌的敏感性 阿莫西林/克拉维酸和氨苄西林/舒巴坦。这两个 抗生素-β-内酰胺酶抑制剂组合已被证明可以 其临床疗效具有可比性，因此应 其体外敏感性结果具有可比性。缺乏 两者之间常规药敏试验结果的相关性 在耐氨苄青霉素大肠杆菌的临床分离株中发现了这些药物。 来自美国国立卫生研究院患者的大肠杆菌。这 通过重复实验来评估结果的再现性 分离株的敏感性测试程序及其有效性 通过其他人进行敏感性测试进一步研究 方法。 182株氨苄青霉素耐药菌株的药敏结果 据透露，阿莫西林/克拉维酸和氨苄西林/舒巴坦具有 初始微量稀释的低相关度 药敏试验程序。这一差异得到了证实 重新测试代表性分离株，以及有效性 另一种敏感性测试程序证实了差异。 在分离株中，75.3% 对阿莫西林/克拉维酸敏感 和氨苄西林/舒巴坦中间或耐药。质粒 进行指纹分析以证明大肠杆菌 分离株代表不同的菌株；因此，有差异的 结果不仅限于一种或几种不寻常的大肠杆菌分离株。 鉴于临床试验的结果表明体内 两个代理的等价性，差异似乎很可能 观察到的结果是建立不适当的断点 由国家临床实验室标准委员会制定。这 对 1-1 期间分离出的所有氨苄青霉素耐药性大肠杆菌进行评估 年期间正在进行中。