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Published on: May 2, 2018

Gram-negative bacterial resistance to cephalosporins in community-acquired infections in Turkey

H Erdem1, S Kiliç, A Pahsa

  • 1Gulhane Military Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey. hakanerdem1969@yahoo.com

Journal of Chemotherapy (Florence, Italy)
|April 15, 2005
PubMed

Insights

Community-acquired Gram-negative bacteria show concerning cephalosporin resistance. Cefepime remains effective, unlike older cephalosporins, highlighting the need for urgent resistance control measures.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Cephalosporins are essential antibiotics, but resistance in community settings is under-researched.
  • Rising antibacterial resistance necessitates understanding local susceptibility patterns.

Purpose of the Study:

  • To determine cephalosporin susceptibility profiles of community-acquired Gram-negative bacteria in Sivas, Turkey.
  • To evaluate the efficacy of various antibiotics against common Gram-negative pathogens.

Main Methods:

  • Analysis of 949 Escherichia coli, 165 Proteus spp., 97 Enterobacter spp., 24 Klebsiella spp., and 84 Pseudomonas aeruginosa isolates.
  • Antimicrobial susceptibility testing for cephalosporins and other agents.

Main Results:

  • Cefepime demonstrated the highest efficacy against Gram-negative isolates (19.3% resistance in P. aeruginosa, 0-10.6% in enteric bacteria).
  • High resistance rates were observed for older cephalosporins (cefazolin: 44.3-100%), while aminoglycosides and ciprofloxacin showed comparable effectiveness to cefepime.
  • First- and second-generation cephalosporins, trimethoprim-sulfamethoxazole, ampicillin, and ampicillin-sulbactam were largely ineffective.

Conclusions:

  • Cephalosporin efficacy in community-acquired infections is declining, necessitating urgent interventions.
  • Aminoglycosides and ciprofloxacin represent viable alternatives to less effective cephalosporins.
  • Antibacterial resistance surveillance and stewardship are crucial outside hospital settings.

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