Which non-carbapenem antibiotics are active against extended-spectrum β-lactamase-producing Enterobacteriaceae?

International audienceWe evaluated the activity of 18 non-carbapenem antibiotics on 100 ESBL-producing Escherichia coli (ESBL-Ec) and 50 ESBL-producing Klebsiella pneumoniae (ESBL-Kp) isolated from urinary tract infections and bacteremia in 2016. MICs were determined using reference methods and susceptibility profiles were defined according to the EUCAST 2017 recommendations. All the ESBL-Ec isolates were susceptible to ceftazidime-avibactam and a great majority of them were susceptible to fosfomycin (98%), piperacillin-tazobactam (97%), amikacin (97%) and nitrofurantoin (96%). Mecillinam, cefoxitin and ceftolozane-tazobactam remained against 92, 83 and 78% of the ESBL-Ec isolates, respectively. 100 %, 94%, and 90% of the ESBL-Kp tested were susceptible to ceftazidime-avibactam, amikacin and mecillinam, respectively. We showed that there are non-carbapenem options for the treatment of all the situations of ESBL-Ec or ESBL-Kp infections, with ceftazidime-avibactam being the most attractive alternative