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Ngoi ST, Muhamad AN, Teh CSJ, Chong CW, Abdul Jabar K, Chai LC, Leong KC, Tee LH, AbuBakar S. β-Lactam Resistance in Upper Respiratory Tract Pathogens Isolated from a Tertiary Hospital in Malaysia. Pathogens 2021; 10:pathogens10121602. [PMID: 34959557 PMCID: PMC8705930 DOI: 10.3390/pathogens10121602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
The rise of antimicrobial resistance (AMR) among clinically important bacteria, including respiratory pathogens, is a growing concern for public health worldwide. Common causative bacteria for upper respiratory tract infections (URTIs) include Streptococcus pneumoniae and Haemophilus influenzae, and sometimes Staphylococcus aureus. We assessed the β-lactam resistant trends and mechanisms of 150 URTI strains isolated in a tertiary care hospital in Kuala Lumpur Malaysia. High rates of non-susceptibility to penicillin G (38%), amoxicillin-clavulanate (48%), imipenem (60%), and meropenem (56%) were observed in S. pneumoniae. Frequent mutations at STMK and SRNVP motifs in PBP1a (41%), SSNT motif in PBP2b (32%), and STMK and LKSG motifs in PBP2x (41%) were observed in S. pneumoniae. H. influenzae remained highly susceptible to most β-lactams, except for ampicillin. Approximately half of the ampicillin non-susceptible H. influenzae harboured PBP3 mutations (56%) and only blaTEM was detected in the ampicillin-resistant strains (47%). Methicillin-susceptible S. aureus (MSSA) strains were mostly resistant to penicillin G (92%), with at least two-fold higher median minimum inhibitory concentrations (MIC) for all penicillin antibiotics (except ticarcillin) compared to S. pneumoniae and H. influenzae. Almost all URTI strains (88-100%) were susceptible to cefcapene and flomoxef. Overall, β-lactam antibiotics except penicillins remained largely effective against URTI pathogens in this region.
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Affiliation(s)
- Soo Tein Ngoi
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (S.T.N.); (A.N.M.); (K.A.J.); (S.A.)
| | - Anis Najwa Muhamad
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (S.T.N.); (A.N.M.); (K.A.J.); (S.A.)
| | - Cindy Shuan Ju Teh
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (S.T.N.); (A.N.M.); (K.A.J.); (S.A.)
- Correspondence: ; Tel.: +603-79676674
| | - Chun Wie Chong
- School of Pharmacy, Monash University Malaysia, Bandar Sunway 47500, Malaysia;
| | - Kartini Abdul Jabar
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (S.T.N.); (A.N.M.); (K.A.J.); (S.A.)
| | - Lay Ching Chai
- Faculty of Science, Institute of Biological Sciences, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
| | - Kin Chong Leong
- Shionogi Singapore Pte Ltd., Anson Road, #34-14 International Plaza, Singapore 079903, Singapore; (K.C.L.); (L.H.T.)
| | - Loong Hua Tee
- Shionogi Singapore Pte Ltd., Anson Road, #34-14 International Plaza, Singapore 079903, Singapore; (K.C.L.); (L.H.T.)
| | - Sazaly AbuBakar
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (S.T.N.); (A.N.M.); (K.A.J.); (S.A.)
- Tropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya, Kuala Lumpur 50603, Malaysia
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Abstract
Many prodrug reviews describe specific examples of the successful application of prodrug technology to produce blockbuster drugs, such as simvastatin, omeprazole, acyclovir and enalapril. These reviews are helpful to understand the previous success stories and case histories of prodrug technology. The aim of the current review seeks to more clearly define quantitative trends in the changes in the physicochemical property parameters between the successful prodrug and the active parent molecule. This information can serve to guide medicinal chemists toward more successful pharmaceutical prodrugs in the future.
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Lee SJ, Ha US, Kim HW, Cho YH. Efficacy of Cefcapene Pivoxil for Empirical Therapy of Acute Uncomplicated Cystitis. Infect Chemother 2008. [DOI: 10.3947/ic.2008.40.3.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Seung-Ju Lee
- Department of Urology, College of Medicine, Catholic University, Seoul, Korea
| | - U-Syn Ha
- Department of Urology, College of Medicine, Catholic University, Seoul, Korea
| | - Hyun Woo Kim
- Department of Urology, College of Medicine, Catholic University, Seoul, Korea
| | - Yong-Hyun Cho
- Department of Urology, College of Medicine, Catholic University, Seoul, Korea
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