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Les infections urinaires Quelle prise en charge en 2017
Gestion des BMR
Nouvelles probleacutematiques et laquo vieux raquo antibiotiques
Aix en Provence 9 mars 2017
H Chardon
Centre Hospitalier du Pays drsquoAix Aix en Provence
Laboratoires SANOFI
Staphylococcus aureus reacutesistant agrave la Meacuteticilline (SARM) Staphylococcus aureus reacutesistant agrave la vancomycine ou teicoplanine Enteacuterobacteacuterie productrice de BLSE (Becircta Lactamase agrave Spectre Elargi) Enteacuterobacteacuterie hyperproductrice de ceacutephalosporinase et non
productrice de BLSE en neacuteonatologie Enteacuterobacteacuterie hyperproductrice de ceacutephalosporinase plasmidiques et
non productrice de BLSE Enterobacteacuterie reacutesistante ou intermeacutediaire agrave limipeacutenegraveme Pseudomonas aeruginosa intermeacutediaire etou reacutesistant agrave la ceftazidime
et agrave limipeacutenegraveme Enteacuterocoque reacutesistant agrave la vancomycine Acinetobacter baumannii intermeacutediaire ou reacutesistant agrave limipeacutenegraveme Acinetobacter baumannii reacutesistant agrave toutes les beacutetalactamines sauf
imipeacutenegraveme Burkholderia cepacia quelque soit lantibiogramme Stenotrophomonas maltophilia quelque soit lantibiogramme
EPC E faecium reacutesistant vancomycine Enteacuterobacteacuterie avec reacutesistance plasmidique agrave
la colistine
PDR pandrug resistance reacutesistant agrave toutes les familles drsquoantibiotiques XDR extensively extreme drug resistance reacutesistant agrave toutes les familles drsquoantibiotiques sauf 1 ou 2 MDR multidrug resistance resistant agrave au moins 3 familles drsquoantibiotiques
Magiorakos CMI 2012
OMS - Communiqueacute de presse - 27 FEacuteVRIER 2017 - GENEgraveVE (mis en forme par lrsquoAFP)
Le nombre de BMR augmente Les BMR tuent
De plus en plus
E coli et C3G EARS-Net European Antimicrobial Resistance Surveillance Network
2005
France 2
2015
11
2014
EARS-Net
K pneumoniae et C3G
2005
France 4
EARS-Net
2015
305
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Laboratoires SANOFI
Staphylococcus aureus reacutesistant agrave la Meacuteticilline (SARM) Staphylococcus aureus reacutesistant agrave la vancomycine ou teicoplanine Enteacuterobacteacuterie productrice de BLSE (Becircta Lactamase agrave Spectre Elargi) Enteacuterobacteacuterie hyperproductrice de ceacutephalosporinase et non
productrice de BLSE en neacuteonatologie Enteacuterobacteacuterie hyperproductrice de ceacutephalosporinase plasmidiques et
non productrice de BLSE Enterobacteacuterie reacutesistante ou intermeacutediaire agrave limipeacutenegraveme Pseudomonas aeruginosa intermeacutediaire etou reacutesistant agrave la ceftazidime
et agrave limipeacutenegraveme Enteacuterocoque reacutesistant agrave la vancomycine Acinetobacter baumannii intermeacutediaire ou reacutesistant agrave limipeacutenegraveme Acinetobacter baumannii reacutesistant agrave toutes les beacutetalactamines sauf
imipeacutenegraveme Burkholderia cepacia quelque soit lantibiogramme Stenotrophomonas maltophilia quelque soit lantibiogramme
EPC E faecium reacutesistant vancomycine Enteacuterobacteacuterie avec reacutesistance plasmidique agrave
la colistine
PDR pandrug resistance reacutesistant agrave toutes les familles drsquoantibiotiques XDR extensively extreme drug resistance reacutesistant agrave toutes les familles drsquoantibiotiques sauf 1 ou 2 MDR multidrug resistance resistant agrave au moins 3 familles drsquoantibiotiques
Magiorakos CMI 2012
OMS - Communiqueacute de presse - 27 FEacuteVRIER 2017 - GENEgraveVE (mis en forme par lrsquoAFP)
Le nombre de BMR augmente Les BMR tuent
De plus en plus
E coli et C3G EARS-Net European Antimicrobial Resistance Surveillance Network
2005
France 2
2015
11
2014
EARS-Net
K pneumoniae et C3G
2005
France 4
EARS-Net
2015
305
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Staphylococcus aureus reacutesistant agrave la Meacuteticilline (SARM) Staphylococcus aureus reacutesistant agrave la vancomycine ou teicoplanine Enteacuterobacteacuterie productrice de BLSE (Becircta Lactamase agrave Spectre Elargi) Enteacuterobacteacuterie hyperproductrice de ceacutephalosporinase et non
productrice de BLSE en neacuteonatologie Enteacuterobacteacuterie hyperproductrice de ceacutephalosporinase plasmidiques et
non productrice de BLSE Enterobacteacuterie reacutesistante ou intermeacutediaire agrave limipeacutenegraveme Pseudomonas aeruginosa intermeacutediaire etou reacutesistant agrave la ceftazidime
et agrave limipeacutenegraveme Enteacuterocoque reacutesistant agrave la vancomycine Acinetobacter baumannii intermeacutediaire ou reacutesistant agrave limipeacutenegraveme Acinetobacter baumannii reacutesistant agrave toutes les beacutetalactamines sauf
imipeacutenegraveme Burkholderia cepacia quelque soit lantibiogramme Stenotrophomonas maltophilia quelque soit lantibiogramme
EPC E faecium reacutesistant vancomycine Enteacuterobacteacuterie avec reacutesistance plasmidique agrave
la colistine
PDR pandrug resistance reacutesistant agrave toutes les familles drsquoantibiotiques XDR extensively extreme drug resistance reacutesistant agrave toutes les familles drsquoantibiotiques sauf 1 ou 2 MDR multidrug resistance resistant agrave au moins 3 familles drsquoantibiotiques
Magiorakos CMI 2012
OMS - Communiqueacute de presse - 27 FEacuteVRIER 2017 - GENEgraveVE (mis en forme par lrsquoAFP)
Le nombre de BMR augmente Les BMR tuent
De plus en plus
E coli et C3G EARS-Net European Antimicrobial Resistance Surveillance Network
2005
France 2
2015
11
2014
EARS-Net
K pneumoniae et C3G
2005
France 4
EARS-Net
2015
305
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
EPC E faecium reacutesistant vancomycine Enteacuterobacteacuterie avec reacutesistance plasmidique agrave
la colistine
PDR pandrug resistance reacutesistant agrave toutes les familles drsquoantibiotiques XDR extensively extreme drug resistance reacutesistant agrave toutes les familles drsquoantibiotiques sauf 1 ou 2 MDR multidrug resistance resistant agrave au moins 3 familles drsquoantibiotiques
Magiorakos CMI 2012
OMS - Communiqueacute de presse - 27 FEacuteVRIER 2017 - GENEgraveVE (mis en forme par lrsquoAFP)
Le nombre de BMR augmente Les BMR tuent
De plus en plus
E coli et C3G EARS-Net European Antimicrobial Resistance Surveillance Network
2005
France 2
2015
11
2014
EARS-Net
K pneumoniae et C3G
2005
France 4
EARS-Net
2015
305
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
PDR pandrug resistance reacutesistant agrave toutes les familles drsquoantibiotiques XDR extensively extreme drug resistance reacutesistant agrave toutes les familles drsquoantibiotiques sauf 1 ou 2 MDR multidrug resistance resistant agrave au moins 3 familles drsquoantibiotiques
Magiorakos CMI 2012
OMS - Communiqueacute de presse - 27 FEacuteVRIER 2017 - GENEgraveVE (mis en forme par lrsquoAFP)
Le nombre de BMR augmente Les BMR tuent
De plus en plus
E coli et C3G EARS-Net European Antimicrobial Resistance Surveillance Network
2005
France 2
2015
11
2014
EARS-Net
K pneumoniae et C3G
2005
France 4
EARS-Net
2015
305
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
OMS - Communiqueacute de presse - 27 FEacuteVRIER 2017 - GENEgraveVE (mis en forme par lrsquoAFP)
Le nombre de BMR augmente Les BMR tuent
De plus en plus
E coli et C3G EARS-Net European Antimicrobial Resistance Surveillance Network
2005
France 2
2015
11
2014
EARS-Net
K pneumoniae et C3G
2005
France 4
EARS-Net
2015
305
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Le nombre de BMR augmente Les BMR tuent
De plus en plus
E coli et C3G EARS-Net European Antimicrobial Resistance Surveillance Network
2005
France 2
2015
11
2014
EARS-Net
K pneumoniae et C3G
2005
France 4
EARS-Net
2015
305
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
E coli et C3G EARS-Net European Antimicrobial Resistance Surveillance Network
2005
France 2
2015
11
2014
EARS-Net
K pneumoniae et C3G
2005
France 4
EARS-Net
2015
305
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
EARS-Net
K pneumoniae et C3G
2005
France 4
EARS-Net
2015
305
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
K pneumoniae et C3G
2005
France 4
EARS-Net
2015
305
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
EARS-Net
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
N BLSE
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
2026 eacutepisodes au total
2009 10 2010 28 2011 113 2012 233 2013 401 2014 650 2015 582
Santeacute Publique France
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Nombre drsquoeacutepisodes drsquoEPC 2012 ndash 2015 par deacutepartement
Taille des eacutepisodes les plus importants (N = 187)
Bilan au 4 septembre 2015 (N= 1 866 eacutepisodes)
Lrsquoanalyse par taille preacutesente uniquement les eacutepisodes les plus importants (ge 15 cas) avec une eacutevolution reacutecente (nouveaux cas lt 6 mois)
Santeacute Publique France
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Proportion de deacutecegraves
attribuables ()
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
2016 - THE REVIEW ON ANTIMICROBIAL RESISTANCE - JIM OrsquoNEILL
DEATHS ATTRIBUTABLE TO AMR EVERY YEAR
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
EARS-Net
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
K pneumoniae820 NET GM TM AN NA CIP OFX LVX SXT
Nb 397 819 670 807 656 816 706 228 766
S 308 687 521 764 452 626 497 200 564
I 14 7 11 14 47 35 24 8 5
R 75 125 138 29 157 155 185 20 197
S 7758 8388 7776 9467 6890 7672 7040 8772 7363
I 353 085 164 173 716 429 340 351 065
R 1889 1526 2060 359 2393 1900 2620 877 2572
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Aztreacuteonam surhelliples carbapeacutenegravemases
(meacutetallo-enzymes)
Nordmann et al Clin Microbiol Infect 2002
Associations ceacutephalosporine(s) hellip + inhibiteur de beacutetalactamases Les pistes qui semblent devoir ecirctre exploreacutees en France sont celles de lrsquoassociation drsquoune C3G et tout particuliegraverement la ceftazidime avec lrsquoacide clavulanique (quitte agrave utiliser lrsquoassociation amoxicilline + acide clavulanique pour disposer drsquoacide clavulanique)
HCSP - 2010
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
CASFM 2016 et EUCAST 2017
CASFM 2017
PSEUDOMONAS
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Les nouveaux inhibiteurs de becircta-lactamase Inhibiteurs de BLSE
NXL 104 - AVIBACTAM
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Lagaceacute-Wiens AAC 2011
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Lagaceacute-Wiens AAC 2011
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
CMI mgL CMI 50 CMI 90 S Ceftazidime ge512 ge512 0 + NXL 104 4 microgL 0125 05 100 2 2 8 100 1 8 8 90 Endimiani AAC 2009
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Sensibiliteacute CAZ CAZ + avib
CEFTAZIDIME ndash AVIBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste compleacutementaire Pseudomonas CASFM 2017
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Sensibiliteacute CAZ CT
CT CEFTOLOZANE ndash TAZOBACTAM Pyo R meacuteropeacutenegraveme BLR Pyo R pipeacuteracilline-tazobactam ceacutefeacutepime meacuteropeacutenegraveme et imipeacutenegraveme Enteacuterobacteacuteries R ceacutefeacutepime CRE K pneumoniae carbapeacutenegraveme-reacutesistant
Gonzalez Ann Lab Med 2017
Liste standard Pseudomonas CASFM 2017
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Neuner AAC 2012 Sensibiliteacute globale 86
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Neuner AAC 2012
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
CH Aix en Provence Disques I2a CASFM 2016 Disque 200 microg
EUCAST 2017 Charge du disque 200 microg
S le 64 mgL R gt 128 mgL (drsquoapregraves CLSI)
S le 32 mgL R gt 32 mgL
Diminution de concentration critique de 64 agrave 32 mgL Augmentation de 8 mm (16 agrave 24 mm) pour une seule dilution N de E coli reacutesistants agrave fosfomycine
Fosfomycine ndash CASFM 2017
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Le gegravene correspondant mcr-1 code une
phosphoeacutethanolamine transfeacuterase plasmidique
qui confegravere un bas niveau de reacutesistance agrave la
colistine (CMI modale 4 microgmL)
Colistine
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Liu YY Wang Y Walsh TR Yi LX Zhang R Spencer J et al
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China a microbiological and molecular biological study
Lancet Infect Dis 2016
The recently discovered mcr-1 gene encodes for a phosphoethanolamine (PEt) transferase that adds PEt to lipid A which reduces the LPS anionic charge and subsequently its affinity to the cationic colistin
Colistine
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Mars 2016
Colistine
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Animal Aliment et Environnement Homme
Eurosurveillance Mars 2016
Colistine
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Cassir Frontiers in Microbiology 2014
Infections caused by multidrug-resistant Gram-negative bacteria successfully treated with old antibiotics
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Reference testing of Enterobacteriaceae Pseudomonas aeruginosa and Acinetobacter spp is by the ISO-standard broth microdilution method (20776-1) a Cation-adjusted Mueller-Hinton Broth is used b No additives may be included in any part of the testing process (in particular no polysorbate-80 or other surfactants) c Trays must be made of plain polystyrene and not treated in any way before use d Sulphate salts of polymyxins must be used (the methanesulfonate derivative of colistin must not be used - it is an inactive pro-drug that breaks down slowly in solution) Susceptibility testing by other methods including agar dilution disk diffusion and gradient diffusion cannot be recommended until historical data have been reviewed or new study data have been generated Work on these methods is ongoing Published on wwweucastorg 22 March 2016
Colistine
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Biocentricreg France
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Dafopoulou AAC 2015
Le gegravene correspondant mcr-1 code une phosphoeacutethanolamine transfeacuterase plasmidique qui confegravere un bas niveau de reacutesistance agrave la colistine (CMI modale 4 microgmL)
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Dafopoulou AAC 2015
HAS laquo Agrave ce jour nous disposons drsquoun recul limiteacute sur les performances du deacutepistage de ces enteacuterobacteacuteries agrave lrsquoaide des meacutethodes automatiseacutees drsquoantibiogramme en milieu liquide raquo
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Thiampheacutenicol
1949 Streptomyces venezuelae 1950 synthegravese 4 diasteacutereacuteoisomegraveres Seul D-threacuteo est antibiotique
F
Florfeacutenicol
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Civljak
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
483 (75) MDR-GNB strains were obtained from 650 consecutive GNB isolated in the Microbiology lab during the six months study period ( resistance to at least three of the different classes of commonly used antimicrobials (Penicillins Cephalosporins Aminoglycosides Flouroquinolones β lactamsβ lactamase inhibitor combinations and Carbapenems)
Smita Sood Journal of Clinical and Diagnostic Research 2016
68 of the MDR GNB isolates were found to be sensitive to chloramphenicol
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Infections caused by multidrug-resistant Gram-positive bacteria successfully treated with old antibiotics
Cassir Frontiers in Microbiology 2014
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Successful treatment of recurrent and complicated urinary tract infection in an immunocompromised patient caused by carbapenem- and colistin-resistant Klebsiella pneumoniae with the association of chloramphenicol and ertapenem
Silvia Figueiredo Costa ECCMID 2016 P6385
Chlorampheacutenicol
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
S le R gt Enteacuterobacteacuteries 8 8 Burkholderia cepacia 8 16 Staphylococcus 8 8 Enterococcus 8 16 Pneumocoque 8 8 Streptocoque heacutemolytique 8 8 Autres streptocoques 8 8 Haemophilus 2 2 Moraxella 2 2 Interpreacutetation valable pour le thiampheacutenicol Remarque preacutesente degraves le communiqueacute depuis toujours et dans le livre laquo Lrsquoantibiogramme raquo Thiampheacutenicol nrsquoest jamais citeacute dans le communiqueacute EUCAST Nrsquoest jamais citeacute dans CLSI
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
0
2000
4000
6000
8000
10000
12000
14000
16000
0032 0064 0125 025 05 1 2 4 8 16 32 64 128
Chlorampheacutenicol
Neisseria meningitidis Haemophilus influenzae
Streptococcus pneumoniae
ECOFF 2 2 8
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
0
1000
2000
3000
4000
5000
6000
05 1 2 4 8 16 32 64 128 256 512
Escherichia coli (EUCAST)
0
5
10
15
20
25
30
05 1 2 4 8 16 32 64 128 256 512
Klebsiella pneumoniae (EUCAST)
CMI Chlorampheacutenicol
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Tableau 2 CMI du chlorampheacutenicol du thiampheacutenicol et du florfeacutenicol vis-agrave-vis de
Escherichia coli et de Staphylococcus aureus selon le meacutecanisme de reacutesistance
Organisme Meacutecanisme de
reacutesistancea CMI (mgL)
Chlorampheacutenicol Thiampheacutenicol Florfeacutenicol E coli sauvage
impermeacuteabiliteacute mutation ribosomale CAT type I CAT type II CAT type III
2 32 32 256 256 512
32 128 512
1024 512
1024
4 32 32 4 4 8
S aureus sauvage CAT cfr
4 64 64
8 512 -
b
2 2
32 a CAT Chlorampheacutenicol aceacutetyltransfeacuterase
b - non deacutetermineacute
laquo Le thiampheacutenicol preacutesente un spectre tregraves large comparable agrave celui du chlorampheacutenicol mais possegravede une activiteacute intrinseacuteque moins importante que ce dernier raquo in laquo Antibiogramme raquo ESKA 3egraveme eacutedition
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
The antibacterial activity of thiamphenicol was compared to that of chloramphenicol against 313 strains of gram-negative bacilli isolated from various clinical specimens These two antiboitics were equally active against the 106 isolates of Haemophilus MIC equals
01 minus 156 mu gml) and against 40 strains of Bacteroides fragilis (almost all strains being inhibited by 125 mugml of the two drugs)
In contrast when compared with chloramphenicol 2-16 times as much of thiamphenicol was required to inhibit Enterobacteriacae making prediction of the susceptibility of these strains to thiamphenicol on the basis of chloramphenicol testing alone likely to be hazardous
Beers DV Chemotherapy 197521(2)73-81
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
Outcomes of patients infected with carbapenemase-producing Klebsiella pneumoniae according to treatment regimen Regimen A inappropriate therapy (no drug was active in vitro) Regimen B monotherapy (one drug was active in vitro) Regimen C combination therapy (two or more drugs were active in vitro) Regimen C1 combination therapy with two or more in vitro-active drugs not including a carbapenem Regimen C2 combination therapy with two or more in vitro-active drugs one of which was a carbapenem Tzouvelekis CMI 2014
hellip et les autres bull Tygeacutecycline bull Teacutemocilline bull Minocycline bull Cotrimoxazole bull Rifampicine bull etchellip hellip en association
