Inactivation of aminoglycosides by beta-lactams of the penicillin and cephalosporin groups

Interaction of carbenicillin with kanamycin, gentamicin, tobramycin, and amikacin, as well as that of cefotaxime with the same aminoglycosides were studied. It was shown that carbenicillin inactivated aminoglycosides in a patient's plasma, urine, rH 5.3-8.44, and in buffer solutions, pH 3.7, 7.5 and 9.25. The inactivation level was the least in acid media. The mechanism of the inactivation was elucidated: opening of the carbenicillin beta-lactam ring occurred at the start.     

Clinical effectiveness of carbenicillin in suppurative inflammatory processes of varying localization]

The study on sensitivity of clinical strains of the causative agents of purulent infections to carbenicillin showed that 34.6% of the staphylococcal strains, 48.1% of the E. coli strains and 40.3% of the Proteus strains were sensitive to the antibiotic. The strains of Ps. aeruginosa were characterized by moderate sensitivity to carbenicillin. The MTC for most of the isolates ranged within 25-128 microgram/ml. High therapeutic efficacy of carbenicillin in treatment of cases with purulent inflammatory processes of various localization was shown. Positive results were obtained in 82.5% of the adults and 76.2% of the premature infants treated with carbenicillin. A satisfactory therapeutic effect was observed in the cases with sepsis, diffuse purulent peritonitis and abscessing pneumonia treated with carbenicillin in combination with gentamicin.     

Susceptibility of Recent Isolates of Pseudomonas aeruginosa to Gentamicin, Polymyxin, and Five Penicillins, with Observations on the Pyocin and Immunotypes of the Strains

The susceptibilities of recently isolated strains of Pseudomonas aeruginosa to gentamicin, polymyxin B, carbenicillin, ampicillin, penicillin G, and two newer penicillins were tested with the inocula-replicating technique by using undiluted and 10(-3) dilutions of the cultures. With either inoculum, polymyxin B was the most active agent, and a comparison with previous data from this laboratory showed that the susceptibility of P. aeruginosa to this antibiotic had not changed over the past 20 years. Gentamicin was nearly as active as polymyxin, all but 2 of the 141 strains tested with the diluted inoculum being inhibited by 6.25 mug/ml or less. AB-2288, an agent resembling carbenicillin, was four times more active than carbenicillin or BLP-1654; the last two were equally active against the 10(-3) inoculum. A more marked inoculum effect was noted with the penicillin analogues tested, the increase in minimum inhibiting concentration with the undiluted culture being eight-fold for carbenicillin and at least 16-fold for AB-2288 and BLP-1654. Pyocin typing and serotyping failed to demonstrate any clearly predominating types.     

In Vitro Studies of Semisynthetic α- (Substituted-Ureido) Penicillins

The activity of three alpha-(substituted-ureido) penicillins was evaluated in vitro against 599 clinical isolates of gram-negative bacilli, by use of the broth-dilution technique. At a concentration of 12.5 mug or less/ml, BL-P1597 inhibited 90% of isolates of Pseudomonas sp., 56% of Enterobacter sp., 67% of indole-positive Proteus spp., 72% of Escherichia coli, and 85% of Proteus mirabilis. BL-P1654 had similar activity, whereas BL-P1532 was much less active. At a concentration of 25 mug or less/ml, BL-P1597 also inhibited nearly 60% of isolates of Klebsiella sp. and nearly 40% of Serratia sp. BL-P1597 and BL-P1654 were as active as ampicillin and carbenicillin against E. coli and P. mirabilis. They were less active than carbenicillin against indole-positive Proteus spp. Both drugs were substantially more active than carbenicillin against Pseudomonas sp. A strain of Pseudomonas sp. which developed resistance to carbenicillin also developed resistance to the alpha-(substituted-ureido) penicillins simultaneously.     

Influence of Serum and Calcium on the Bactericidal Activity of Gentamicin and Carbenicillin on Pseudomonas aeruginosa

Because calcium was found to be antagonistic in vitro to the activity of colistin and polymyxin B on Pseudomonas aeruginosa, the effects of calcium and serum on gentamicin and carbenicillin were also examined. Serum was antagonistic to gentamicin in antibiotic tube dilution tests on five strains of P. aeruginosa. Serum was not antagonistic to carbenicillin in tube dilution tests. Physiologic concentrations of calcium antagonized the activity of gentamicin but not carbenicillin. The antagonism observed with gentamicin was less than that previously seen with colistin. The antagonistic effect of calcium and serum was removed by a chelating agent. Gentamicin and carbenicillin may be more active in vivo against P. aeruginosa than colistin or polymyxin B.     

Interpretation of Diffusion Susceptibility Data Obtained with 50-μg Carbenicillin Discs Against Gram-Negative Organisms

A total of 284 clinical isolates of various species of Enterobacteriaceae, Pseudomonas aeruginosa, P. maltophilia, and Acinetobacter anitratum were tested for susceptibility to carbenicillin by the standardized Bauer-Kirby disc diffusion technique and a microtiter broth dilution method. The data obtained led to the following proposed criteria for the interpretation of the results of disc susceptibility tests. Enterobacteriaceae that yield zones of inhibition equal to or greater than 20 mm in diameter around 50-mug discs of carbenicillin are designated as sensitive to the drug; isolates that yield zones measuring from 18 to 19 mm in diameter are reported as of equivocal (intermediate) susceptibility to the drug, whereas those enterobacterial isolates that are characterized by zones of inhibition of 17 mm or less in diameter are interpreted as resistant to carbenicillin. Isolates of P. aeruginosa, P. maltophilia, and A. anitratum yielding zones of 14 mm or more in diameter around 50-mug discs of carbenicillin are reported as sensitive, whereas those isolates that are characterized by zones of 13 mm or less in diameter are reported as resistant to this drug.     

抗生素对农杆菌的抑制和对油菜外植体分化的影响

通过哌拉青霉素、氨苄青霉素、青霉素钠、羧苄青霉素、头孢拉定、头孢唑啉钠、磷霉素钠、乳糖酸红霉素、白霉素9种抗生素对根癌农杆菌EHA105和LBA4404的抑制效果,以及对油菜子叶柄分化影响的研究,结果表明：羧苄青霉素在500mg／L时对农杆菌EHA105的抑菌效果最好,而其它8种抗生素对EHA105无明显的抑菌作用;对于LBA4404浓度为200mg／L的羧苄青霉素、氨苄青霉素和头孢唑啉钠都有良好的抑菌效果。不同抗生素对油菜子叶柄的分化试验结果表明,羧苄青霉素和头孢唑啉钠对离体油菜子叶柄再生分化及生长没有影响,磷霉素钠、乳糖酸红霉素、自霉素几乎完全抑制了油菜子叶柄分化。同时对卡那霉素(作为筛选剂)的浓度进行了筛选,确定了油菜33B的筛选浓度为15mg／L,油菜918B的筛选浓度为10mg／L。     

Procedures for the Assay of Carbenicillin in Body Fluids

The assay of carbenicillin in clinical specimens is complicated by the fact that carbenicillin also contains a small amount of benzylpenicillin, thereby precluding the use of conventional penicillin assay organisms. This report gives details of a microbiological assay method involving the use of a strain of Pseudomonas aeruginosa which is very sensitive to carbenicillin but insensitive to benzylpenicillin. The outline of a microassay method with this organism is presented, and a method for the assay of specimens containing mixtures of carbenicillin and other antibiotics is described.     

Carbenicillin in the treatment of acute and chronic bacterial pneumonias]

A total of 50 patients suffering from acute and chronic bacterial pneumonia were treated with sodium carbenicillin. The bacteriological analysis of the sputum showed that Str. pneumoniae predominated in the monoculture or its association with other bacteria. Connection of the results of the bacteriological analysis with the clinical efficiency of the therapy was studied. When carbenicillin was administered intramuscularly in a dose of 1 gm, its therepeutic effect was maintained in the blood for 4 to 6 hours. A satisfactory clinical effect was registered in 41 out of 50 patients treated with carbenicillin in a daily dose 4--6 gm for 8--10 days. No toxic effect of carbenicillin on the parenchimatous organs and peripheral blood was noted.     

Val-237 for Ala substitution in the TEM-2 β-lactamase dramatically alters the catalytic efficiencies towards carbenicillin and ticarcillin

Abstract The mutant 554 of TEM-2 β-lactamase was selected for a decrease in the resistance to carbenicillin of an Escherichia coli K12 carrier. The amino acid sequence of the mutant β-lactamase was determined by manual Edman degradation analysis of proteolytic peptides. A single substitution Val for Ala was localized at position 237. The mutant exhibited only 2% of the catalytic efficiency of the wild-type enzyme towards carbenicillin and ticarcillin, whereas it retained 30–60% of the hydrolytic activity towards other penicillin and cephalosporin substrates. Carfecillin, the phenyl ester of the side-chain carboxyl group of carbenicillin, was hydrolysed as a good substrate. This suggests that the behaviour of the mutant enzyme towards carbenicillin may result from ionic rather than steric constraints. A molecular model of the Val-237 TEM-2 mutant suggests possible electrostatic interaction between Glu-171 and the carboxylic group of the side chain of carbenicillin.     

Synergistic activity of gentamicin plus carbenicillin upon Pseudomonas aeruginosa: its relationship with pyocin and antibiotic susceptibility.

The synergistic effect of combinations of gentamicin and carbenicillin, as well as the type or subtype of the pyocins produced, were investigated in 170 strains of Pseudomonas aeruginosa isolated from clinical specimens. A high proportion of strains were synergistically inhibited (73.5%), but among strains producing pyocins 7, 14 and 31, synergy was infrequent or absent. The synergistic effect was more frequent upon gentamicin- or carbenicillin-susceptible strains. However, among untypable strains, synergy was more frequent among gentamicin-resistant strains. Susceptibility to both gentamicin and carbenicillin must be considered if antibiotic susceptibility is to be related to synergy.     

Experimental study of antibacterial activity, therapeutic effectiveness and toxic properties of the combination of tobramycin and carbenicillin

Tobramycin combination with carbenicillin was studied experimentally. Tobramycin is a new aminoglycoside antibiotic prepared at the Institute of New Antibiotics, the USSR Academy of Medical Sciences. It was shown that the combination had mainly synergistic action (67 per cent) on clinical strains of Pseudomonas aeruginosa which was confirmed in treatment of experimental sepsis caused by the organism. In acute experiments with albino mice there was observed summation of the general toxic action of the antibiotics used in the combination. The level and nature of the nephrotoxic action of the tobramycin combination with carbenicillin were shown in experiments with rats to be the same as those of the nephrotoxic action of tobramycin used alone. The presence of carbenicillin in the combination did not increase the inhibitory effect of tobramycin on excitement transmission in the neuromuscular synapses.     

Carbenicillin as Inhibitor of β-Lactamase from <Emphasis Type="Italic">Pseudomonas aeruginosa</Emphasis>

CARBENICILLIN was produced as a new, semi-synthetic penicillin with antibacterial activity against Pseudomonas aeruginosa and some other microorganisms¹, but this compound was known to be destroyed by staphylococcal penicillinase². Newsom et al.³ described the substrate profile of a constitutive β-lactamase from one strain of Pseudomonas aeruginosa and reported the hydrolysis of carbenicillin at a rate higher than benzylpenicillin. When compared with the inducible enzyme described by Sabath et al.⁴, it differed both in the substrate profile and the ability to hydrolyse carbenicillin. Lack of activity of the inducible enzyme on carbenicillin was also reported by Garber and Friedman⁵ when studying eight strains of Pseudomonas aeruginosa. Sykes and Richmond⁶ were able to identify three types of β-lactamases among fifty-six strains of Pseudomonas aeruginosa according to induci-bility, substrate profile and activity on carbenicillin. Type I (Sabath et al.⁴) was inducible, highly active on cephaloridine and showed no activity on carbenicillin. Types II (Sykes and Richmond⁷) and III (Newsom et al.³) were constitutive and inactivated carbenicillin at different rates. Only the constitutive enzymes conferred resistance towards carbenicillin. We have investigated the activity on carbenicillin of β-lactamases from strains of Pseudomonas aeruginosa isolated from clinical specimens. Activity on benzylpenicillin and cephaloridine was also studied.     

In Vitro Effects of Carbenicillin Combined with Gentamicin or Polymyxin B Against Pseudomonas aeruginosa

Disodium carbenicillin and gentamicin sulfate have both shown promise in the treatment of infections caused by Pseudomonas aeruginosa. This study was designed to explore possible synergistic relationships among the new as well as the established antimicrobial agents used to treat such infections. With an agar dilution technique, minimum inhibitory concentrations of 27 strains of P. aeruginosa were determined in two-dimensional tests. Graphs of equal biological activity (isobolograms) demonstrated moderate synergistic effects of the carbenicillin-gentamicin combination over therapeutically feasible concentration ranges. In contrast, the combination of carbenicillin and polymyxin B showed only additive or slightly antagonistic effects. Tests of bacterial killing confirmed the presence of carbenicillin-gentamicin synergy in 3 of 6 strains of P. aeruginosa, but did not show true antagonism between carbenicillin and polymyxin B. Clinical trials of both drug combinations are advisable to determine whether therapeutic results can be improved, and whether the dosages of gentamicin or polymyxin B can thereby be reduced to lessen their toxic hazards.     

Sensitivity of clinical Proteus strains to antibiotics and their combinations]

In 1976 isolation of Proteus from wounds of patients with various purulent processes amounted to 14.5 per cent. Serotypes 0-10, 0-3 and H-3 predominated among the isolates. Sensitivity of 35 clinical strains of Proteus to 10 antibiotics, furagin and nevigramone was studied by the method of serial dilutions in liquid media. All the isolates were highly resistant to the antibiotics except gentamicin, furagin and nevigramone, the MIC of which for most of the strains was 3.12, 1.6-3.12 and 6.25-12.5 gamma/ml, respectively. The effect of 14 combinations of chemotherapeutics was also studied. The combinations of gentamicin with carbenicillin, gentamicin with ampicillin and monomycin with ampicillin proved to be most effective against the Proteus strains tested. The following combinations may be of practical value: monomycin + carbenicillin, kanamycin + ampicillin, kanamycin + carbenicillin, ampicillin + furagin, gentamicin + nevigramone. The combinations of carbenicillin with furagin and gentamicin with furagin were also rational.     

Comparative study of the antibacterial activity of aminoglycoside antibiotics and their combinations with carbenicillin against Pseudomonas aeruginosa

Antibacterial activity of 7 aminoglycoside antibiotics and combinations of tobramycin or gentamicin with carbenicillin was studied with respect to 33 clinical strains of Ps. aeruginosa. Tobramycin, sisomicin, gentamicin and amicacin showed high levels of antibacterial activity. Tobramycin and sisomicin were 3-4 and 2 times more effective than gentamicin. 100 per cent of the Ps. aeruginosa isolates was sensitive to tobramycin and amicacin. The number of the isolates sensitive to sisomicin and gentamicin amounted to 97 and 94 per cent respectively. The respective numbers for streptomycin and kanamycin were 32 and 11 per cent. No monomycin sensitive isolates were detected. Combination of tobramycin or gentamicin with carbenicillin increased the antibacterial activity of the aminoglycoside antibiotics by 2-16 times and that of carbenicillin by 2-32 times. The synergistic effect of gentamicin or tobramycin with carbenicilin was observed with respect to 50 and 58 per cent of the isolates respectively. No antagonistic effect was detected on the combined use of the antibiotics. The majority of the isolates (96 per cent) were sensitive to combinations of carbenicillin in a concentration of 50 micrograms/ml with tobramycin or gentamicin in concentrations of 0.15 or 0.3 micrograms/ml respectively.     

In Vitro Susceptibility of Pseudomonas aeruginosa to Carbenicillin and the Combination of Carbenicillin and Gentamicin

One hundred and eleven strains of Pseudomonas aeruginosa isolated from clinical material were studied for susceptibility to carbenicillin. Of the strains, 80% were inhibited by 125 mug/ml or more. The combination of carbenicillin and gentamicin was shown to have inhibitory and bactericidal synergistic effect on 15 of 16 strains of P. aeruginosa tested. There was poor correlation between the single-disc sensitivity method and the tube dilution method.     

Conjugative R plasmids isolated from hospital strains of Pseudomonas aeruginosa]

It was shown that Pseudomonas aeruginosa hospital strains isolated from patients and environment in the Republican Centre of Burns in Tbilisi contained conjugative R plasmids. The plasmids were marked pM15 and pM19, respectively. The plasmid pM15 determined resistance to carbenicillin, kanamycin and tetracycline and plasmid pM19 determined resistance to carbenicillin, kanamycin, tetracycline, chloramphenicol, gentamicin and streptomycin. Plasmid pM15 had a molecular weight of 45.8 MD and seven sites for EcoRI, six sites for HindIII and five sites for Hpa-I-restrictase. This plasmid, as others, belongs to the Inc-P1 incompatibility group.     

Surprisingly fast disappearance of beta-lactam selection pressure in cultivation as detected with novel biosensing approaches

Tetracycline and beta-lactam resistances among others are used as selection markers in the production of recombinant proteins. The beta-lactam resistance is based on degradation, i.e. the selection pressure gradually disappears from the culture, whereas tetracycline resistance is based on active efflux. We have studied the kinetics of the stability of antibiotic selection pressure in culture using a simple model system (pBR322 in Escherichia coli). Concentrations of ampicillin, carbenicillin and tetracycline were measured with novel sensor cells developed in our lab. These cells are specifically induced to produce light in the presence of the drugs and here their performance was shown to be excellent in monitoring antibiotic concentrations in cell culture. The sensor cells are cheap to produce and use and a high number of samples can be analysed simultaneously. To our surprise, ampicillin and carbenicillin were completely degraded after 2.5-3.0 h of culture, although it has been widely claimed that especially carbenicillin is a good selective agent, whereas tetracycline was stable in culture. beta-lactamase activity in culture was found to correlate with the kinetics of ampicillin degradation.     

Various methods to assay carbenicillin activity against Pseudomonas aeruginosa]

It was shown that the cultures of Pseudomonas aeruginosa were sensitive to 75-100 micrograms/ml and resistant to 25-50 micrograms/ml of carbenicillin when tested by the method of serial dilutions in the synthetic medium developed by the authors and in Jorgensen's medium. The cultures were incubated for 4 and 16 hours, respectively. The data did not confirm the resistance of the cultures to 25-75 and 100 micrograms/ml carbenicillin when it was determined with the serial dilution method in Pal's medium and the disk diffusion method, respectively. The advantages of the medium developed by the authors for testing P. aeruginosa sensitivity to carbenicillin are discussed.