Current and Emerging Treatment Options for Multidrug Resistant <i>Escherichia coli</i> Urosepsis: A Review
<i>Escherichia coli</i> is a versatile commensal and pathogenic member of the human microflora. As the primary causative pathogen in urosepsis, <i>E. coli</i> places an immense burden on healthcare systems worldwide. To further exacerbate the issue, multi drug resistance (MDR...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/12/1821 |
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| author | Mikaela M. Walker Jason A. Roberts Benjamin A. Rogers Patrick N. A. Harris Fekade B. Sime |
| author_facet | Mikaela M. Walker Jason A. Roberts Benjamin A. Rogers Patrick N. A. Harris Fekade B. Sime |
| author_sort | Mikaela M. Walker |
| collection | DOAJ |
| description | <i>Escherichia coli</i> is a versatile commensal and pathogenic member of the human microflora. As the primary causative pathogen in urosepsis, <i>E. coli</i> places an immense burden on healthcare systems worldwide. To further exacerbate the issue, multi drug resistance (MDR) has spread rapidly through <i>E. coli</i> populations, making infections more troublesome and costlier to treat. This paper aimed to review the literature concerning the development of MDR in uropathogenic <i>E. coli</i> (UPEC) and explore the existing evidence of current and emerging treatment strategies. While some MDR strains maybe treated with β-lactam-β-lactamase inhibitor combinations as well as cephalosporins, cephamycin, temocillin and fosfomycin, current treatment strategies for many MDR UPEC strains are reliant on carbapenems. Carbapenem overreliance may contribute to the alarming dissemination of carbapenem-resistance amongst some UPEC communities, which has ushered in a new age of difficult to treat infections. Alternative treatment options for carbapenem resistant UPEC may include novel β-lactam-β-lactamase or carbapenemase inhibitor combinations, cefiderocol, polymyxins, tigecycline, aminoglycosides or fosfomycin. For metallo-β-lactamase producing strains (e.g., NDM, IMP-4), combinations of cefazidime-avibacam with aztreonam have been used. Additionally, the emergence of new antimicrobials brings new hope to the treatment of such infections. However, continued research is required to successfully bring these into the clinic for the treatment of MDR <i>E. coli</i> urosepsis. |
| first_indexed | 2024-03-09T17:24:13Z |
| format | Article |
| id | doaj.art-98c99b9fe0014ac285d052556c3abe99 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T17:24:13Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-98c99b9fe0014ac285d052556c3abe992023-11-24T12:54:59ZengMDPI AGAntibiotics2079-63822022-12-011112182110.3390/antibiotics11121821Current and Emerging Treatment Options for Multidrug Resistant <i>Escherichia coli</i> Urosepsis: A ReviewMikaela M. Walker0Jason A. Roberts1Benjamin A. Rogers2Patrick N. A. Harris3Fekade B. Sime4UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, QLD 4029, AustraliaUQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, QLD 4029, AustraliaMonash Infectious Diseases, Monash Health, Melbourne, VIC 3168, AustraliaUQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, QLD 4029, AustraliaUQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, QLD 4029, Australia<i>Escherichia coli</i> is a versatile commensal and pathogenic member of the human microflora. As the primary causative pathogen in urosepsis, <i>E. coli</i> places an immense burden on healthcare systems worldwide. To further exacerbate the issue, multi drug resistance (MDR) has spread rapidly through <i>E. coli</i> populations, making infections more troublesome and costlier to treat. This paper aimed to review the literature concerning the development of MDR in uropathogenic <i>E. coli</i> (UPEC) and explore the existing evidence of current and emerging treatment strategies. While some MDR strains maybe treated with β-lactam-β-lactamase inhibitor combinations as well as cephalosporins, cephamycin, temocillin and fosfomycin, current treatment strategies for many MDR UPEC strains are reliant on carbapenems. Carbapenem overreliance may contribute to the alarming dissemination of carbapenem-resistance amongst some UPEC communities, which has ushered in a new age of difficult to treat infections. Alternative treatment options for carbapenem resistant UPEC may include novel β-lactam-β-lactamase or carbapenemase inhibitor combinations, cefiderocol, polymyxins, tigecycline, aminoglycosides or fosfomycin. For metallo-β-lactamase producing strains (e.g., NDM, IMP-4), combinations of cefazidime-avibacam with aztreonam have been used. Additionally, the emergence of new antimicrobials brings new hope to the treatment of such infections. However, continued research is required to successfully bring these into the clinic for the treatment of MDR <i>E. coli</i> urosepsis.https://www.mdpi.com/2079-6382/11/12/1821multidrug resistanceurosepsis<i>Escherichia coli</i>MRE |
| spellingShingle | Mikaela M. Walker Jason A. Roberts Benjamin A. Rogers Patrick N. A. Harris Fekade B. Sime Current and Emerging Treatment Options for Multidrug Resistant <i>Escherichia coli</i> Urosepsis: A Review Antibiotics multidrug resistance urosepsis <i>Escherichia coli</i> MRE |
| title | Current and Emerging Treatment Options for Multidrug Resistant <i>Escherichia coli</i> Urosepsis: A Review |
| title_full | Current and Emerging Treatment Options for Multidrug Resistant <i>Escherichia coli</i> Urosepsis: A Review |
| title_fullStr | Current and Emerging Treatment Options for Multidrug Resistant <i>Escherichia coli</i> Urosepsis: A Review |
| title_full_unstemmed | Current and Emerging Treatment Options for Multidrug Resistant <i>Escherichia coli</i> Urosepsis: A Review |
| title_short | Current and Emerging Treatment Options for Multidrug Resistant <i>Escherichia coli</i> Urosepsis: A Review |
| title_sort | current and emerging treatment options for multidrug resistant i escherichia coli i urosepsis a review |
| topic | multidrug resistance urosepsis <i>Escherichia coli</i> MRE |
| url | https://www.mdpi.com/2079-6382/11/12/1821 |
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