A Prospective, Observational and Comparative Study of In-Vitro Susceptibility of Isepamicin against Clinical Isolates from Various Clinical Sources (Triple I Study - Isepamicin in India)
Objectives: This study aims to investigate the in-vitro susceptibility of clinical isolates against Isepamicin and compared it with Gentamicin and Amikacin.
Patients and Methods: In this multicentre prospective study, clinical specimens of patients were collected from three different regions of India. Clinical isolates from urine, intra-abdominal, broncho-alveolar lavage, endotracheal secretion, and sterile blood were included. The E-test was used to quantify the minimal inhibitory concentration (MIC) for Isepamicin, Gentamicin, and Amikacin. The percentages of bacterial isolates were categorized as susceptible, intermediate, and resistant according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines as per Comité de l'Antibiogramme de la Société Française de Microbiologie (CA-SFM) recommendation.
Results: A total of 8 different bacterial isolates were collected from 150 clinical samples obtained from 50 patients. Respiratory (63 [42%]) and urine (44 [29.3%]) specimens were the most common sources for bacterial strains. The most identified bacterial isolates were K. pneumoniae (40 [26.6%]) and P. aeruginosa (38 [25%]). Isepamicin was found to be highly effective in urine samples and showed excellent sensitivity against E. coli (93.3%), followed by P. aeruginosa (57.9%) and K. pneumoniae (55.0%). Antimicrobial sensitivity was highest for Isepamicin (60/108 [56%]) at MIC≤1 mg/L and was most effective against Gram-negative bacterial isolates from the intensive care units (ICUs).
Conclusions: Isepamicin could treat E. coli infections and could be an effective therapy in the treatment of urinary tract infections (UTIs). Moreover, it could also be used as an alternative to Gentamicin and Amikacin against resistant cases.
Keywords: Aminoglycosides, Amikacin, E. coli, Gentamicin, Gram-negative bacteria, Isepamicin.
2. Flores-Mireles AL, Walker JN, Caparon M. et al. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. N reviews microb. 2015; 13(5):269-84. https://doi.org/10.1038/nrmicro3432 PMid:25853778 PMCid:PMC4457377
3. Venkataraman R, Divatia JV, Ramakrishnan N et al. Multicenter observational study to evaluate epidemiology and resistance patterns of common intensive care unit-infections. Ind J of Crit Care Medi: Peer-reviewed, Official Publication of Indian Soci of Crit Care Medi. 2018; 22(1):20. https://doi.org/10.4103/ijccm.IJCCM_394_17 PMid:29422728 PMCid:PMC5793017
4. Breijyeh Z, Jubeh B, Karaman R. Resistance of gram-negative bacteria to current antibacterial agents and approaches to resolve it. Molecules. 2020; 25(6):1340. https://doi.org/10.3390/molecules25061340 PMid:32187986 PMCid:PMC7144564
5. Kirst, H. A., & Allen, N. E. (2006). Aminoglycosides antibiotics. Comprehensive Medicinal Chemistry II; 629-652, Elsevier. https://doi.org/10.1016/B0-08-045044-X/00281-9
6. Rajni E, Jain A, Garg VK. et al. Providencia Causing Urinary Tract Infections: Are We Reaching a Dead End?. Ind J of Crit Care Medi: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine. 2022; 26(4):446. https://doi.org/10.5005/jp-journals-10071-24163 PMid:35656046 PMCid:PMC9067475
7. Maraki S, Samonis G, Karageorgopoulos DE. et al. In vitro antimicrobial susceptibility to isepamicin of 6,296 Enterobacteriaceae clinical isolates collected at a tertiary care university hospital in Greece. Anti-agents and chemo. 2012; 56(6):3067-73. https://doi.org/10.1128/AAC.06358-11 PMid:22391548 PMCid:PMC3370768
8. Carbon C. Overview of the efficacy of isepamicin in the adult core clinical trial programme. J of Chemo (Florence, Italy). 1995; 7:79-85.
9. Menon T, Bindu D, Kumar CP. et al. Comparison of double disc and three dimensional methods to screen for ESBL producers in a tertiary care hospital. Ind J of Medi Micro. 2006; 24(2):117-20. https://doi.org/10.4103/0255-0857.25192 PMid:16687862
10. Miller GH, Chiu PJ, Waitz JA. Biological activity of Sch 21420, the 1-NS-α-hydroxy-β- aminopropionyl derivative of gentamicin B. The J of antibio. 1978; 31(7):688-96. https://doi.org/10.7164/antibiotics.31.688 PMid:690004
11. Jones RN, Johnson DM, Barrett MS. et al. Antimicrobial activity of isepamicin (SCH21420, 1-N-HAPA gentamicin B) combinations with cefotaxime, ceftazidime, ceftriaxone, ciprofloxacin, imipenem, mezlocillin and piperacillin tested against gentamicin-resistant and susceptible gram-negative bacilli and enterococci. J of chemo. 1991; 3(5):289-94. https://doi.org/10.1080/1120009X.1991.11739108 PMid:1809808
12. Liu JY, Wang FD, Ho MW. et al. In vitro activity of aminoglycosides against clinical isolates of Acinetobacter baumannii complex and other nonfermentative Gram-negative bacilli causing healthcare-associated bloodstream infections in Taiwan. J of Micro, Immu and Infect. 2016; 49(6):918-23. https://doi.org/10.1016/j.jmii.2015.07.010 PMid:26364729
13. Wang G, Song G, Xu Y. A Rapid Antimicrobial Susceptibility Test for Klebsiella pneumoniae Using a Broth Micro-Dilution Combined with MALDI TOF MS. Infect and dru resist. 2021; 14:1823. https://doi.org/10.2147/IDR.S305280 PMid:34025124 PMCid:PMC8132464
14. Paul D, Anto N, Bhardwaj M. et al. Antimicrobial resistance in patients with suspected urinary tract infections in primary care in Assam, Ind Antimicro Resist. 2021; 3(4):164. https://doi.org/10.1093/jacamr/dlab164 PMid:34917941 PMCid:PMC8669238
15. Falagas ME, Karageorgopoulos DE, Georgantzi GG. et al. Susceptibility of Gram-negative bacteria to isepamicin: a systematic review. Exp rev of anti-infect ther. 2012; 10(2):207-18. https://doi.org/10.1586/eri.11.170 PMid:22339194
16. Yeliz TC, Ali HB, Sarah AF. et al. Investigation of isepamicin in-vitro efficiency in Gram negative bacteria. Ind J of Medi Micro. 2021; 39(1):59-62. https://doi.org/10.1016/j.ijmmb.2020.09.003 PMid:33610258
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