In vitro Activities of Mecillinam Against Clinical Isolates of Enterobacteriaceae

Chang-Ki Kim; Jong Hwa Yum; Sang-Guk Lee; Yangsoon Lee; Jun Yong Choi; June Myung Kim; Kyungwon Lee; Yunsop Chong

doi:10.3947/ic.2009.41.3.174

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Kim, Yum, Lee, Lee, Choi, Kim, Lee, and Chong: In vitro Activities of Mecillinam Against Clinical Isolates of Enterobacteriaceae

Original Article

Infection and Chemotherapy

Infection and Chemotherapy 2009; 41(3): 174-180.

Published online: 30 June 2009

DOI: https://doi.org/10.3947/ic.2009.41.3.174

In vitro Activities of Mecillinam Against Clinical Isolates of Enterobacteriaceae

Chang-Ki Kim, M.D.¹, Jong Hwa Yum, Ph.D.², Sang-Guk Lee, M.D.^3,⁴, Yangsoon Lee, M.D.^3,⁴, Jun Yong Choi, M.D.⁵, June Myung Kim, M.D.⁵, Kyungwon Lee, M.D.^3,⁴, Yunsop Chong, Ph.D.^3,⁴

¹Korean Institute of Tuberculosis, The Korean National Tuberculosis Association, Seoul, Korea.

²Department of Biomedical Laboratory Science, Dong-Eui University College of Natural Science, Busan, Korea.

³Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.

⁴Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.

⁵Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Correspondence author:Kyungwon Lee, M.D. Department of Laboratory Medicine, Yonsei University College of Medicine, 134 Shinchondong, Seodaemunku, Seoul 120-752, Korea. Tel:+82-2-2228-2446. Fax:+82-2-313-0908, leekcp@yuhs.ac

Received 28 April 2009 Accepted 17 June 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Mecillinam, an amidinopenicillin antibiotic, has been used to treat urinary tract infections and bacterial enteritis in many countries. In this study, we evaluated in vitro activity of mecillinam against Enterobacteriaceae isolates from urine, and Salmonella and Shigella isolates from patients with bacterial gastroenteritis.

Materials and Methods

A total of 308 clinical strains were collected and were comprised of Escherichia coli (n=109), Klebsiella pneumoniae (n=52), Enterobacter spp. (n=30), Serratia marcescens (n=30) and Proteus spp. (n=29) isolated from a university hospital in Korea in 2007, and of Salmonella spp. (n=28) and Shigella spp. (n=30) isolated from Korean diarrheal patients from 2001 to 2006. Antimicrobial susceptibility was tested by Clinical Laboratory Standard Institute (CLSI) agar dilution method. CLSI breakpoint of mecillinam for E. coli urinary tract isolates was applied to all other isolates.

Results

In E. coli, rate of susceptibility to ampicillin was 30%, but 99-100% to amikacin and cefotaxime. Most (96%) of E. coli isolates, including extended-spectrum β-lactamase (ESBL) producers, were susceptible to mecillinam. All ESBL producers, except for one isolate, were inhibited by ≤4 µg/mL of mecillinam. MIC₉₀ of mecillinam for K. pneumoniae and Enterobacter spp. was 8 µg/mL and 1 µg/mL, respectively, and the susceptibility rate was 92% and 97%, respectively. However, MIC₉₀ of mecillinam for S. marcescens isolates was >128 µg/mL and most of them were resistant to mecillinam. All Salmonella isolates and 27 of 30 Shigella isolates were susceptible to mecillinam.

Conclusion

Mecillinam was active in vitro against most Enterobacteriaceae, Salmonella, and Shigella isolates except for S. marcescens. Therefore, mecillinam can be a good alternative agent for treating urinary tract infection and bacterial gastroenteritis.

Keywords: Mecillinam, Enterobacteriaceae, In vitro activity

Figures and Tables

Table 1

Activities of Antimicrobial agents against Escherichia coli Isolates from Urine

Table 2

Activities of Antimicrobial agents against Klebsiella pneumoniae Isolates from Urine

Table 3

Activities of Antimicrobial agents against other Enterobacteriaceae Isolates from Urine

-, Not applicable

Table 4

Activities of Antimicrobial agents against Salmonella spp. Isolates from Stool

Table 5

Activities of Antimicrobial agents against Shigella spp. Isolates from Stool

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