Extended spectrum beta-lactamases (ESBLs) usually associated with multiple drug resistance, including beta-lactam and non-beta-lactam antibiotics. This resistance can cause Limitation in the choice of drugs appropriate for using in clinical practice, especially in life-threatening infections. In this study we aimed to investigate in vitro activity of meropenem, ciprofloxacine and amikacin against ESBL-producing and non-producing blood isolates of Escherichia coli and Klebsiella pneumoniae strains. Fifty-eight E. coli (21 ESBL-producing, 37 non-ESBL producing) and 99 K. pneumoniae (54 ESBL-producing, 45 non-ESBL producing) strains were included in the study. The presence of ESBL was investigated by double disk synergy test and E-test methods. Antibiotic susceptibility test was done by microdilution method according to NCCLS guideline. In vitro susceptibilities of ESBL producing E. coli and K. pneumoniae strains were found as 100% for meropenem, 33.3% and 25.9% for ciprofloxacine, 94.5% and 83.3% for amikacin. It was observed that; meropenem was equally active agent in both ESBL-producing and non-producing strains, and its activity was not affected by ESBL production. Whereas amikacin activity was minimally affected and ciprofloxacine activity was markedly decreased by ESBL production. In conclusion, meropenem seems to be better choice of antibiotic should be used for ESBL positive life-threatening infections, because of remaining highest activity.

中文翻译：

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三种不同的抗菌剂对产生ESBL的大肠杆菌和肺炎克雷伯菌的血液分离物的体外活性。

广谱β-内酰胺酶（ESBLs）通常与多种耐药性有关，包括β-内酰胺和非β-内酰胺抗生素。这种抗药性可能会导致在临床实践中尤其是威胁生命的感染中选择合适的药物时受到限制。在这项研究中，我们旨在研究美罗培南，环丙沙星和丁胺卡那霉素对产生ESBL和不产生大肠杆菌和肺炎克雷伯菌的血液分离株的体外活性。本研究包括58株大肠杆菌（21株ESBL产生，37株非ESBL产生）和99株肺炎克雷伯菌（54株ESBL产生，45株非ESBL产生）。通过双盘协同试验和E检验方法研究了ESBL的存在。根据NCCLS指南，通过微量稀释法进行抗生素敏感性试验。发现产生ESBL的大肠杆菌和肺炎克雷伯菌菌株的体外药敏性为美罗培南为100％，环丙沙星为33.3％和25.9％，丁胺卡那霉素为94.5％和83.3％。据观察，美罗培南在产生ESBL和不产生ESBL的菌株中均是同等活性剂，其活性不受ESBL产生的影响。然而，ESBL的产生对丁胺卡那霉素的活性影响最小，环丙沙星活性显着降低。总之，美罗培南似乎是更好的抗生素选择，因为它具有最高的活性，因此应用于ESBL阳性威胁生命的感染。美罗培南在产生ESBL和不产生ESBL的菌株中均是同等活性剂，其活性不受ESBL产生的影响。然而，ESBL的产生对丁胺卡那霉素的活性影响最小，环丙沙星活性显着降低。总之，美罗培南似乎是更好的抗生素选择，因为它具有最高的活性，因此应用于ESBL阳性威胁生命的感染。美罗培南在产生ESBL和不产生ESBL的菌株中均是同等活性剂，其活性不受ESBL产生的影响。然而，ESBL的产生对丁胺卡那霉素的活性影响最小，环丙沙星活性显着降低。总之，美罗培南似乎是更好的抗生素选择，因为它具有最高的活性，因此应用于ESBL阳性威胁生命的感染。