In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 8 ( 2023-8-4), p. e0288660-
Abstract:
OXA-48 carbapenemases are frequently expressed by Klebsiella pneumoniae clinical isolates; they decrease the effectiveness of carbapenem therapy, particularly with meropenem. Among these isolates, meropenem-susceptible carbapenemase-producers may show decreased meropenem effectiveness. However, the probability of the emergence of resistance in susceptible carbapenemase-producing isolates and its dependence on specific K . pneumoniae meropenem MICs is not completely known. It is also not completely clear what resistance patterns will be exhibited by these bacteria exposed to meropenem, if they would follow the patterns of non-beta-lactamase-producing bacteria and other than beta-lactams antibiotics. These issues might be clarified if patterns of meropenem resistance related to the mutant selection window (MSW) hypothesis. To test the applicability of the MSW hypothesis to meropenem, OXA-48-carbapenemase-producing K . pneumoniae clinical isolates with MICs in a 64-fold range (from susceptible to resistant) were exposed to meropenem in a hollow-fiber infection model; epithelial lining fluid meropenem pharmacokinetics were simulated following administration of 2 grams every 8 hours in a 3-hour infusion. Strong bell-shaped relationships between the meropenem daily dose infused to the model as related to the specific isolate MIC and both the antimicrobial effect and the emergence of resistance were observed. The applicability of the MSW hypothesis to meropenem and carbapenemase producing K . pneumoniae was confirmed. Low meropenem efficacy indicates very careful prescribing of meropenem to treat K . pneumoniae infections when the causative isolate is confirmed as an OXA-48-carbapenemase producer.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0288660
DOI:
10.1371/journal.pone.0288660.g001
DOI:
10.1371/journal.pone.0288660.g002
DOI:
10.1371/journal.pone.0288660.g003
DOI:
10.1371/journal.pone.0288660.g004
DOI:
10.1371/journal.pone.0288660.g005
DOI:
10.1371/journal.pone.0288660.g006
DOI:
10.1371/journal.pone.0288660.g007
DOI:
10.1371/journal.pone.0288660.g008
DOI:
10.1371/journal.pone.0288660.t001
DOI:
10.1371/journal.pone.0288660.s001
DOI:
10.1371/journal.pone.0288660.s002
DOI:
10.1371/journal.pone.0288660.s003
DOI:
10.1371/journal.pone.0288660.s004
DOI:
10.1371/journal.pone.0288660.s005
DOI:
10.1371/journal.pone.0288660.s006
DOI:
10.1371/journal.pone.0288660.r001
DOI:
10.1371/journal.pone.0288660.r002
DOI:
10.1371/journal.pone.0288660.r003
DOI:
10.1371/journal.pone.0288660.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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