IN VITRO ASSESSMENT OF MEROPENEM–VABORBACTAM AGAINST CARBAPENEM-RESISTANT ESCHERICHIA COLI IN A TERTIARY CARE SETTING

Abstract

ABSTRACT

Background: Carbapenem-resistant Escherichia coli is an ongoing problem in healthcare settings, especially in the less developed parts of the world where antibiotics are misused and overused. Even though new combinations like meropenem–vaborbactam are introduced, the effectiveness is still determined by the local resistance patterns.

Objectives: To assess the in-vitro activity of meropenem–vaborbactam against carbapenem-resistant E. coli isolates from clinical specimens in a tertiary care hospital in Lahore.

Methods: A total of 94 non-duplicate carbapenem-resistant E. coli isolates were collected over a six-month period for this cross-sectional study. Microbiological methods and VITEK-2 system were used for the identification of isolates. Testing of antimicrobial susceptibility was done by disc diffusion and MIC methods according to CLSI 2023–2024 guidelines. The analyzed data was processed with SPSS version 26.0.

Results: The isolates were found to be all resistant to the carbapenems, third- and fourth-generation cephalosporins, ciprofloxacin, and piperacillin–tazobactam. Resistance was also detected at high levels against aminoglycosides and other non-β-lactam agents. Activity for meropenem–vaborbactam was limited to 10% of isolates being susceptible.

Conclusion: Multidrug resistance is widespread among the carbapenem-resistant E. coli isolates, and the in-vitro effectiveness of meropenem–vaborbactam is low in this region. The monitoring of antibiotic resistance at the local level, along with the development of the right strategies for the use of antimicrobials, is necessary for establishing the right treatment.