DOI: 10.11648/j.ijpc.20261202.12 ISSN: 2575-5749

Comparative Activity of Carbapenems (Biapenem/Merapenem) in the Therapy of Carbapenemase-Producing Enterobacterales

Doev Petrovich
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Carbapenem antibiotics continue to hold a leading position in the treatment of hospital-acquired infections. However, since the mid-2000s, the importance of this group of antibiotics has gradually declined due to the spread of resistance to them. Although resistance to carbapenems is mediated by various factors, the most important is the production of β–lactamases, in particular carbapenemases. All beta-lactamases are divided into four classes. In the Russian highest percentages are for OXA-48 and NDM, at 75% and 18%, respectively. In 6% of cases, both carbapenemases OXA-48+NDM were detected, and the frequency of KPC carbapenemase was 1%. Data on the sensitivity of bacteria producing carbapenemases to biapenem and meropenem is contradictory. In this regard, the purpose of this study was to compare the activity of bipenem and meropenem against Enterobacterales (Klebsiella pneumonia and Escherichia coli) that produce carbapenemases. The study included 32 isolates of gram-negative flora of the enterobacterales family. Sensitivity testing for biapenem and meropenem was performed using the method of microdilution in a liquid culture medium in accordance with GOST R ISO 20776-1-2022, with determination of the minimum inhibitory concentration (MIC). The identified carbapenemases in enterobacterales were distributed as follows: NDM carbapenemase producers-15 isolates, OXA-48 carbapenemase producers-13 isolates, NDM+OXA-48 carbapenemase producers-1 isolates and KPC carbapenemase producers-3 isolate. Four of the fifteen NDM-producing isolates, the MIC for biapenem was in the intermediate zone, i.e. less than 8 mg/L, while the MIC for meropenem was in the non-sensitive zone for all fifteen isolates, i.e. more than 8 mg/L. Among the OXA-48-producing isolates, three of the thirteen showed susceptibility to biapenem, with an MIC of less than 2 mg/L, while only one isolate showed susceptibility to meropenem, with an MIC in the intermediate zone (4-8 mg/L). For the NDM+OXA-48 and KPC -producing isolates the MIC of both antibiotics were in the non-susceptible zone, i.e. > 8 mg/L. Biapenem is a new member of the carbapenem antibiotics, showing good activity against Enterobacteriaceae producing carbapenemases NDM and OXA-48 types. Given the greater sensitivity to it among the isolates of this type of bacteria, this drug may have an advantage among other members of the carbapenems.

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