Therapeutic Options for Metallo-β-Lactamase-Producing Enterobacterales
Xing Tan,1 Hwan Seung Kim,1 Kimberly Baugh,2 Yanqin Huang,1 Neeraja Kadiyala,1 Marisol Wences,1 Nidhi Singh,1 Eric Wenzler,1 Zackery P Bulman1 1Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA; 2Franciscan Health Hammond/Dyer, Hammond, IN, USAC...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2021-01-01
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| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/therapeutic-options-for-metallo-beta-lactamase-producing-enterobactera-peer-reviewed-article-IDR |
| _version_ | 1818612105605021696 |
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| author | Tan X Kim HS Baugh K Huang Y Kadiyala N Wences M Singh N Wenzler E Bulman ZP |
| author_facet | Tan X Kim HS Baugh K Huang Y Kadiyala N Wences M Singh N Wenzler E Bulman ZP |
| author_sort | Tan X |
| collection | DOAJ |
| description | Xing Tan,1 Hwan Seung Kim,1 Kimberly Baugh,2 Yanqin Huang,1 Neeraja Kadiyala,1 Marisol Wences,1 Nidhi Singh,1 Eric Wenzler,1 Zackery P Bulman1 1Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA; 2Franciscan Health Hammond/Dyer, Hammond, IN, USACorrespondence: Zackery P Bulman Department of Pharmacy PracticeCollege of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886), Chicago, IL 60612, USATel +1 312-996-1415Fax +1 312-413-1797Email bulman@uic.eduAbstract: The spread of metallo-β-lactamase (MBL)-producing Enterobacterales worldwide without the simultaneous increase in active antibiotics makes these organisms an urgent public health threat. This review summarizes recent advancements in diagnostic and treatment strategies for infections caused by MBL-producing Enterobacterales. Adequate treatment of patients infected with MBL-producing Enterobacterales relies on detection of the β-lactamase in the clinic. There are several molecular platforms that are currently available to identify clinically relevant MBLs as well as other important serine-β-lactamases. Once detected, there are several antibiotics that have historically been used for the treatment of MBL-producing Enterobacterales. Antimicrobials such as aminoglycosides, tetracyclines, fosfomycin, and polymyxins often show promising in vitro activity though clinical data are currently lacking to support their widespread use. Ceftazidime-avibactam combined with aztreonam is promising for treatment of infections caused by MBL-producing Enterobacterales and currently has the most clinical data of any available antibiotic to support its use. While cefiderocol has displayed promising activity against MBL-producing Enterobacterales in vitro and in preliminary clinical studies, further clinical studies will better shed light on its place in treatment. Lastly, there are several promising MBL inhibitors in the pipeline, which may further improve the treatment of MBL-producing Enterobacterales.Keywords: metallo-β-lactamase, Enterobacterales, carbapenemase, ceftazidime-avibactam, aztreonam, rapid diagnostics |
| first_indexed | 2024-12-16T15:40:56Z |
| format | Article |
| id | doaj.art-5f2be08212a24ad0b09b00c9e268a42b |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-12-16T15:40:56Z |
| publishDate | 2021-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-5f2be08212a24ad0b09b00c9e268a42b2022-12-21T22:26:00ZengDove Medical PressInfection and Drug Resistance1178-69732021-01-01Volume 1412514261285Therapeutic Options for Metallo-β-Lactamase-Producing EnterobacteralesTan XKim HSBaugh KHuang YKadiyala NWences MSingh NWenzler EBulman ZPXing Tan,1 Hwan Seung Kim,1 Kimberly Baugh,2 Yanqin Huang,1 Neeraja Kadiyala,1 Marisol Wences,1 Nidhi Singh,1 Eric Wenzler,1 Zackery P Bulman1 1Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA; 2Franciscan Health Hammond/Dyer, Hammond, IN, USACorrespondence: Zackery P Bulman Department of Pharmacy PracticeCollege of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886), Chicago, IL 60612, USATel +1 312-996-1415Fax +1 312-413-1797Email bulman@uic.eduAbstract: The spread of metallo-β-lactamase (MBL)-producing Enterobacterales worldwide without the simultaneous increase in active antibiotics makes these organisms an urgent public health threat. This review summarizes recent advancements in diagnostic and treatment strategies for infections caused by MBL-producing Enterobacterales. Adequate treatment of patients infected with MBL-producing Enterobacterales relies on detection of the β-lactamase in the clinic. There are several molecular platforms that are currently available to identify clinically relevant MBLs as well as other important serine-β-lactamases. Once detected, there are several antibiotics that have historically been used for the treatment of MBL-producing Enterobacterales. Antimicrobials such as aminoglycosides, tetracyclines, fosfomycin, and polymyxins often show promising in vitro activity though clinical data are currently lacking to support their widespread use. Ceftazidime-avibactam combined with aztreonam is promising for treatment of infections caused by MBL-producing Enterobacterales and currently has the most clinical data of any available antibiotic to support its use. While cefiderocol has displayed promising activity against MBL-producing Enterobacterales in vitro and in preliminary clinical studies, further clinical studies will better shed light on its place in treatment. Lastly, there are several promising MBL inhibitors in the pipeline, which may further improve the treatment of MBL-producing Enterobacterales.Keywords: metallo-β-lactamase, Enterobacterales, carbapenemase, ceftazidime-avibactam, aztreonam, rapid diagnosticshttps://www.dovepress.com/therapeutic-options-for-metallo-beta-lactamase-producing-enterobactera-peer-reviewed-article-IDRmetallo-β-lactamaseenterobacteralescarbapenemaseceftazidime-avibactamaztreonamrapid diagnostics |
| spellingShingle | Tan X Kim HS Baugh K Huang Y Kadiyala N Wences M Singh N Wenzler E Bulman ZP Therapeutic Options for Metallo-β-Lactamase-Producing Enterobacterales Infection and Drug Resistance metallo-β-lactamase enterobacterales carbapenemase ceftazidime-avibactam aztreonam rapid diagnostics |
| title | Therapeutic Options for Metallo-β-Lactamase-Producing Enterobacterales |
| title_full | Therapeutic Options for Metallo-β-Lactamase-Producing Enterobacterales |
| title_fullStr | Therapeutic Options for Metallo-β-Lactamase-Producing Enterobacterales |
| title_full_unstemmed | Therapeutic Options for Metallo-β-Lactamase-Producing Enterobacterales |
| title_short | Therapeutic Options for Metallo-β-Lactamase-Producing Enterobacterales |
| title_sort | therapeutic options for metallo beta lactamase producing enterobacterales |
| topic | metallo-β-lactamase enterobacterales carbapenemase ceftazidime-avibactam aztreonam rapid diagnostics |
| url | https://www.dovepress.com/therapeutic-options-for-metallo-beta-lactamase-producing-enterobactera-peer-reviewed-article-IDR |
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