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by Bhoj Singh
in Noto-are Medicine, June 3, 2018. (14947537)
The study evaluated in vitro utility of beta-lactamase inhibitors added indiscriminately with most of the therapeutically used beta-lactam antibiotics (BLA). The common trend among clinicians is to use beta-lactams and beta-lactamase inhibitor (BLI) combinations instead of just BLAs because of the vigorously propagated concept that combinations (BLA BLI) have wider antibiotic spectrum and stability than the BLA alone. Data analysis of antimicrobial sensitivity patterns from the clinical epidemiology laboratory (2011-2017) for bacterial isolates from veterinary clinical cases revealed that out of 3233 bacterial isolates 2.8% (91) were tested resistant to BLA BLI discs while they were sensitive to the same BLA used alone. The observation warns against the indiscriminate use of BLA-BLI combinations. Detection of BLI induced resistance to BLAs in Gram-positive, Gram-negative, oxidase positive and oxidase negative bacteria indicated the widespread occurrence of the trait among bacteria. However, further studies are required to understand the mechanism of induction of BLA resistance by BLIs.
Table. 1a. Resistance to β-lactam antibiotics (BLA) in bacteria isolated from veterinary clinical cases and shown induction of resistance to one or more BLAs in presence of β-lactamase inhibitors (BLIs).
Table. 1b. Resistance to β-lactam antibiotics (BLA) in bacteria isolated from veterinary clinical cases and shown induction of resistance to one or more BLAs in presence of β-lactamase inhibitors (BLIs).
D-effect of amoxycillin + clavulanic (AMC) acid on ceftazidime (CAZ) and ceftazidime + clavulanic acid (CAZ-CLA) zones, the test strains (Serratia odorifera) was sensitive to amoxycillin but resistant to amoxycillin + clavulanic acid, and equally sensitive to cefepime (PM) and cefepime +clavulanic acid (PML).
Sensitivity of Staphylococcus cohnii to cefotaxime (CTX) which had resistance to cefotaxime + clavulanic acid (CTX-CLA).
Streptococcus porcinus was sensitive to cefotaxime (CTX) but resistance to cefotaxime + clavulanic acid (CTX-CLA), however,equally sensitive to pipearcillin tazobactam (PZT) and piperacillin (PIP), resistant to ceftazidime (CAZ) as well as ceftazidime + clavulanic acid (CAZ-CLA).
Pseudomonas aeruginosa sensitivity assay, the strain was resistant to cefotaxime + clavulanic acid (CTX-CLA) but sensitive to cefotaxime (CTX), intermediate sensitive to cefepime (PM, MIC= 3 µg/ mL) but resistant to cefepime clavulanic acid (PML, MIC >4 µg/ mL), sensitive to ceftazidime (TZ, MIC=1.5 µg/ mL) and resistant to ceftazime + clavulanic acid (TZL, MIC > 4 µg/ mL).