In Vitro Activity of Cefaclor/Beta-Lactamases Inhibitors (Clavulanic Acid and Sulbactam) Combination Against Extended-Spectrum Beta-Lactamase Producing Uropathogenic E. coli

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I whakaputaina i:Antibiotics vol. 14, no. 6 (2025), p. 603
Kaituhi matua: Atoom Ali
Ētahi atu kaituhi: Alzubi Bayan, Barakat, Dana, Abu-Gheyab, Rana, Ismail-Agha, Dalia, Al-Kaabneh Awatef, Numan Nawfal
I whakaputaina:
MDPI AG
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Urunga tuihono:Citation/Abstract
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LEADER 00000nab a2200000uu 4500
001 3223866836
003 UK-CbPIL
022 |a 2079-6382 
024 7 |a 10.3390/antibiotics14060603  |2 doi 
035 |a 3223866836 
045 2 |b d20250101  |b d20251231 
084 |a 231335  |2 nlm 
100 1 |a Atoom Ali  |u Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman 19328, Jordan; bayann2000@gmail.com (B.A.); danabarakat46@gmail.com (D.B.); ranaabugheyab@gmail.com (R.A.-G.); daloubaidy@yahoo.com (D.I.-A.) 
245 1 |a In Vitro Activity of Cefaclor/Beta-Lactamases Inhibitors (Clavulanic Acid and Sulbactam) Combination Against Extended-Spectrum Beta-Lactamase Producing Uropathogenic <i>E. coli</i> 
260 |b MDPI AG  |c 2025 
513 |a Journal Article 
520 3 |a Background: Urinary tract infections (UTIs) caused by the multidrug resistance (MDR) phenotype termed extended-spectrum beta lactamase (ESBL)-producing E. coli is a significant and growing global health concern. In response to the rising prevalence, the novel Beta Lactam-Beta Lactamase inhibitor (BL/BLI) combinations have been introduced in recent years. While these agents have shown efficacy, their clinical utility is constrained by high cost, limited availability, and emerging resistance mechanisms. The rational of this study was to test the in vitro activity of a cost-effective alternative to currently available BL–BLI combinations against ESBL-producing E. coli isolated from urinary tract infections (UTIs). Objective: This study investigates the in vitro antimicrobial activity of cefaclor (CFC), both as monotherapy and in combination with the β-lactamase inhibitors clavulanic acid (CA) and sulbactam (SUL), against 52 ESBL-producing E. coli isolates derived from urine cultures of patients diagnosed with UTIs. Methods: The susceptibility ranges were measured by disk diffusion and minimal inhibitory concentration (MIC) methods. In addition, the Time kill assay and disk approximation method were performed to measure the synergistic and bactericidal activity of the approached combination. Results: The MIC50 and MIC90 for CFC were improved from more than 128 µg/mL to 8/4 µg/mL when CFC was combined with either CA or SUL. The triple combination format of CFC/CA/SUL showed MIC50 and MIC90 values at 8/4/4 µg/mL and 64/32/32 µg/mL, respectively. The recovered susceptibility percentages were 54%, 54%, and 58% for CFC/CA, CFC/SUL, and CFC/CA/SUL combinations, respectively. Disk approximation and time–kill assay results revealed synergy and bactericidal effects when CFC combined with CA or SUL for isolates that showed susceptibility restorations of CFC when coupled with CA or SUL by the disk diffusion and MIC method. Conclusions: This study proposes a cost-effective combination that could mitigate resistance development and offer a sparing option to last resort treatment choices including carbapenems. However, testing efficacy in a clinical setting is crucial. 
653 |a Urogenital system 
653 |a In vitro methods and tests 
653 |a Sulbactam 
653 |a Urinary tract 
653 |a Acids 
653 |a Public health 
653 |a Phenotypes 
653 |a Bacteria 
653 |a Clavulanic acid 
653 |a Approximation 
653 |a Availability 
653 |a E coli 
653 |a Amides 
653 |a Cefaclor 
653 |a Genotype & phenotype 
653 |a Multidrug resistance 
653 |a Cost effectiveness 
653 |a Bactericidal activity 
653 |a Urinary tract diseases 
653 |a Urinary tract infections 
653 |a Inhibitors 
653 |a Approximation method 
653 |a Minimum inhibitory concentration 
653 |a Bacterial infections 
653 |a Antimicrobial agents 
653 |a Carbapenems 
653 |a Global health 
653 |a Streptococcus infections 
653 |a Enzymes 
653 |a β Lactamase 
653 |a Antimicrobial activity 
700 1 |a Alzubi Bayan  |u Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman 19328, Jordan; bayann2000@gmail.com (B.A.); danabarakat46@gmail.com (D.B.); ranaabugheyab@gmail.com (R.A.-G.); daloubaidy@yahoo.com (D.I.-A.) 
700 1 |a Barakat, Dana  |u Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman 19328, Jordan; bayann2000@gmail.com (B.A.); danabarakat46@gmail.com (D.B.); ranaabugheyab@gmail.com (R.A.-G.); daloubaidy@yahoo.com (D.I.-A.) 
700 1 |a Abu-Gheyab, Rana  |u Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman 19328, Jordan; bayann2000@gmail.com (B.A.); danabarakat46@gmail.com (D.B.); ranaabugheyab@gmail.com (R.A.-G.); daloubaidy@yahoo.com (D.I.-A.) 
700 1 |a Ismail-Agha, Dalia  |u Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman 19328, Jordan; bayann2000@gmail.com (B.A.); danabarakat46@gmail.com (D.B.); ranaabugheyab@gmail.com (R.A.-G.); daloubaidy@yahoo.com (D.I.-A.) 
700 1 |a Al-Kaabneh Awatef  |u Princess Iman Center for Research and Laboratory Sciences, Jordanian Royal Medical Services, Amman 11855, Jordan; awatef.kaabneh@jrms.gov.jo 
700 1 |a Numan Nawfal  |u College of Pharmacy, The University of Mashreq, Baghdad 10023, Iraq; nawfal.am.numan@uom.edu.iq 
773 0 |t Antibiotics  |g vol. 14, no. 6 (2025), p. 603 
786 0 |d ProQuest  |t Biological Science Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3223866836/abstract/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text + Graphics  |u https://www.proquest.com/docview/3223866836/fulltextwithgraphics/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3223866836/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch