COMPARATIVE EFFICACY OF IMIPENEM AND CEFTOLOZANE/TAZOBACTAM IN TREATING MDR-PSEUDOMONAS AERUGINOSA URINARY TRACT INFECTIONS
Main Article Content
Keywords
Imipenem (I), Ceftolozane/Tazobactum (CT), UTI, MDR-Pseudomonas aeruginosa
Abstract
Background: UTI, one of the most prevalent illnesses in modern medicine, it affects patients of all ages, from newborns to the elderly. Urinary tract pathogens possess virulence characteristics that facilitate their attachment to mucosal surfaces and consequent infection. Sepecifically we chose Pseudomonas aeruginosa (P.aeruginosa) in our study, it is an obligate gram negative, rod-shaped bacilli, which impart blue-green color in a culture plate. Our research drugs are Imipenem(I) and Ceftolozane are abroad-spectrum carbapenem antibiotic that is effective against many Gram-negative and Gram-positive bacteria, including Pseudomonas aeruginosa.
Objective: To compare the Efficacy of Imipenem and Ceftolozane/Tazobactam in Treating MDR-Pseudomonas aeruginosa Urinary Tract Infections.
Methods: An in-vitro pre-clinical experimental study was carried out at University of Karachi, from December 2022 to May 2023. A total of 40 isolates per group were collected for evaluation of antibacterial activity. The experimental samples of MDR-P were collected from Microbiology Laboratory, University of Karachi. Antibacterial activity of antibiotics was determined using Disc Diffusion method.
Conclusion: MDR P. aeruginosa strains exhibit significant resistance to imipenem, but CT, a novel antibiotic, shows increased efficacy against these multidrug-resistant bacteria, indicating a potential alternative to imipenem in treating UTI.
References
2. ALLEN, T., GYRD-HANSEN, D., KRISTENSEN, S. R., OXHOLM, A. S., PEDERSEN, L. B. & PEZZINO, M. 2022. Physicians under pressure: evidence from antibiotics prescribing in England. Medical Decision Making, 42, 303-312.
3. ALRAHMANY, D. & GHAZI, I. M. 2020. Molecular Basis of Resistance II. 21st Century Challenges in Antimicrobial Therapy and Stewardship, 3, 104.
4. ALVAREZ-BUYLLA, A., ALLEN, M., BETTS, D., BENNETT, S., MONAHAN, I., PLANCHE, T. & WOOTTON MANDY, I. S. G. A. C. B. K. C. H. D. A. M. D. M. E. S. N. E. W. H. A. L. J. P. J. P. T. P. M. W. P. 2020. Multicentre study of the in vitro activity of ceftolozane/tazobactam and other commonly used antibiotics against Pseudomonas aeruginosa isolates from patients in the UK. JAC-Antimicrobial Resistance, 2, dlaa024.
5. ARMSTRONG, T., FENN, S. J. & HARDIE, K. R. 2021. JMM Profile: Carbapenems: a broad-spectrum antibiotic. Journal of medical microbiology, 70, 001462.
6. BASSETTI, M., KANJ, S. S., KIRATISIN, P., RODRIGUES, C., VAN DUIN, D., VILLEGAS, M. V. & YU, Y. 2022. Early appropriate diagnostics and treatment of MDR Gram-negative infections. JAC-Antimicrobial Resistance, 4, dlac089.
7. BASSETTI, M., PEGHIN, M., VENA, A. & GIACOBBE, D. R. 2019. Treatment of infections due to MDR Gram-negative bacteria. Frontiers in medicine, 6, 74.
8. BIELEN, L. & LIKIC, R. 2019. Experience with fosfomycin in the treatment of complicated urinary tract infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae. Therapeutic advances in infectious disease, 6, 2049936119858883.
9. BUTLER, A. M., DURKIN, M. J., KELLER, M. R., MA, Y., POWDERLY, W. G. & OLSEN, M. A. 2022. Association of adverse events with antibiotic treatment for urinary tract infection. Clinical Infectious Diseases, 74, 1408-1418.
10. CHEN, L., HUA, J., HONG, S.-J., YUAN, C.-Y., JING, R.-C., LUO, X.-Y., XUE, H.-W., YUE, Y. & HE, X.-P. 2023. Comparison of the relative efficacy of β-lactam/β-lactamase inhibitors and carbapenems in the treatment of complicated urinary tract infections caused by ceftriaxone-non-susceptible Enterobacterales: a multicentre retrospective observational cohort study. Journal of Antimicrobial Chemotherapy, 78, 710-718.
11. DAIKOS, G. L., DA CUNHA, C. A., ROSSOLINI, G. M., STONE, G. G., BAILLON-PLOT, N., TAWADROUS, M. & IRANI, P. 2021. Review of ceftazidime-avibactam for the treatment of infections caused by Pseudomonas aeruginosa. Antibiotics, 10, 1126.
12. DOUGNON, V., ASSOGBA, P., ANAGO, E., DÉGUÉNON, E., DAPULIGA, C., AGBANKPÈ, J., ZIN, S., AKOTÈGNON, R., MOUSSA, L. B. & BANKOLÉ, H. 2020. Enterobacteria responsible for urinary infections: a review about pathogenicity, virulence factors and epidemiology. Journal of Applied Biology & Biotechnology Vol, 8, 117-124.
13. FAROOQ, L., MEMON, Z., ISMAIL, M. O. & SADIQ, S. 2019. Frequency and antibiogram of multi-drug resistant pseudomonas aeruginosa in a Tertiary Care Hospital of Pakistan. Pakistan journal of medical sciences, 35, 1622.
14. GALANI, I., PAPOUTSAKI, V., KARANTANI, I., KARAISKOS, I., GALANI, L., ADAMOU, P., DELIOLANIS, I., KODONAKI, A., PAPADOGEORGAKI, E. & MARKOPOULOU, M. 2020. In vitro activity of ceftolozane/tazobactam alone and in combination with amikacin against MDR/XDR Pseudomonas aeruginosa isolates from Greece. Journal of Antimicrobial Chemotherapy, 75, 2164-2172.
15. GARCIA, Í. R., DE OLIVEIRA GARCIA, F. A., PEREIRA, P. S., COUTINHO, H. D. M., SIYADATPANAH, A., NOROUZI, R., WILAIRATANA, P., DE LOURDES PEREIRA, M., NISSAPATORN, V. & TINTINO, S. R. 2022. Microbial resistance: The role of efflux pump superfamilies and their respective substrates. Life Sciences, 295, 120391.
16. GAUTAM, T. 2019. Isolation, Speciation and Detection of Virulence Factors in Pseudomonas Species with Special Reference to Metallo-Betalactamase Production. Rajiv Gandhi University of Health Sciences (India).
17. GODMAN, B., EGWUENU, A., HAQUE, M., MALANDE, O. O., SCHELLACK, N., KUMAR, S., SALEEM, Z., SNEDDON, J., HOXHA, I. & ISLAM, S. 2021. Strategies to improve antimicrobial utilization with a special focus on developing countries. Life, 11, 528.
18. GOMIS-FONT, M. A., CABOT, G., LÓPEZ-ARGÜELLO, S., ZAMORANO, L., JUAN, C., MOYÁ, B. & OLIVER, A. 2022. Comparative analysis of in vitro dynamics and mechanisms of ceftolozane/tazobactam and imipenem/relebactam resistance development in Pseudomonas aeruginosa XDR high-risk clones. Journal of Antimicrobial Chemotherapy, 77, 957-968.
19. HAFIZ, T. A., BIN ESSA, E. A., ALHARBI, S. R., ALYAMI, A. S., ALKUDMANI, Z. S., MUBARAKI, M. A., ALTURKI, N. A. & ALOTAIBI, F. 2023. Epidemiological, microbiological, and clinical characteristics of multi-resistant Pseudomonas aeruginosa isolates in King Fahad Medical City, Riyadh, Saudi Arabia. Tropical Medicine and Infectious Disease, 8, 205.
20. HAMDANI, S. S., BHAT, B. A., TARIQ, L., YASEEN, S. I., ARA, I., RAFI, B., HAMDANI, S. N., HASSAN, T. & RASHID, O. 2020. Antibiotic resistance: the future disaster. International Journal for Research in Applied Sciences and Biotechnology, 7.
21. HASAN, S. A., NAJATI, A. M. & ABASS, K. S. 2020. Prevalence and antibiotic resistance of “pseudomonas aeruginosa” isolated from clinical samples in Kirkuk City, Iraq. Eurasia J Biosci, 14, 1821-5.
22. LIZZA, B. D., BETTHAUSER, K. D., RITCHIE, D. J., MICEK, S. T. & KOLLEF, M. H. 2021. New perspectives on antimicrobial agents: ceftolozane-tazobactam. Antimicrobial agents and chemotherapy, 65, 10.1128/aac. 02318-20.
23. MAKLED, A. F., ALI, S. A., MAHMOUD, A. B., ELTOUKHY, M. E., ELKHOLY, R. M., LASHEEN, A. F. & ELBROLOSY, A. M. 2023. Colistin Resistance among Enterobacterales Isolates: Underlying Mechanisms and Alternative Treatment Options. Journal of Pure & Applied Microbiology, 17.
24. MOHIUDDIN, A. K. 2023. Taking medicine in the right way–most important but most neglected. European Journal of Clinical and Experimental Medicine, 152-159.
25. MORRIS, S. & CERCEO, E. 2020. Trends, epidemiology, and management of multi-drug resistant gram-negative bacterial infections in the hospitalized setting. Antibiotics, 9, 196.
26. PAPROCKA, P., DURNAŚ, B., MAŃKOWSKA, A., KRÓL, G., WOLLNY, T. & BUCKI, R. 2022. Pseudomonas aeruginosa infections in cancer patients. Pathogens, 11, 679.
27. SALAM, M. A., AL-AMIN, M. Y., SALAM, M. T., PAWAR, J. S., AKHTER, N., RABAAN, A. A. & ALQUMBER, M. A. Antimicrobial resistance: a growing serious threat for global public health. Healthcare, 2023. MDPI, 1946.
28. VARELA, M. F., STEPHEN, J., LEKSHMI, M., OJHA, M., WENZEL, N., SANFORD, L. M., HERNANDEZ, A. J., PARVATHI, A. & KUMAR, S. H. 2021. Bacterial resistance to antimicrobial agents. Antibiotics, 10, 593.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Marium Tariq
Research Associate Quality Assurance, Center for Bioequivalence Studies and Clinical Research (CBSCR), International Center for Chemical and Biological Sciences (ICCBS)
Afshan Siddiq
Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi.
Hira Ahmed
Lecturer, Department of Pharmacognosy, Faculty of Pharmacy, Hamdard University, Karachi.
Lubna Farooq
Assistant Professor, Department of Pharmacology, Baqai Medical University, Karachi.
Nimra Khan
Lecturer, Department of Pharmacy Practice, Baqai Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi.
Saira Faraz Shah
Lecturer, Department of Pharmacy, Nazeer Hussain University, Karachi.
Sumreen Mujahid
Senior lecturer, Department of Pharmacology and Therapeutic, Baqai Medical College, Baqai Medical University, Karachi.