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Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
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Increased cefepime MIC for enterobacteriacae clinical isolates.

Narges Najafi1, Ahmad Alikhani, Farhang Babamahmoudi

  • 1Tropical Medicine and Microbial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

Caspian Journal of Internal Medicine
|September 7, 2013
PubMed
Summary

Cefepime demonstrated high resistance rates in treating ventilator-associated pneumonia (VAP) caused by common bacteria like E. coli and K. pneumoniae in Iran. This suggests cefepime is not a suitable empirical choice for VAP.

Keywords:
CefepimeEnterobacteriacaeICUMICVAP

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Cefepime is frequently used for empirical treatment of ventilator-associated pneumonia (VAP).
  • VAP is often caused by Gram-negative and Gram-positive bacteria.
  • Understanding local antimicrobial susceptibility patterns is crucial for effective treatment.

Purpose of the Study:

  • To determine the antimicrobial susceptibility pattern of cefepime against microorganisms causing VAP.
  • To evaluate the effectiveness of cefepime as an empirical treatment for VAP in Mazandaran, Iran.

Main Methods:

  • The study included VAP patients diagnosed with clinical pulmonary infection score (CPIS) in intensive care units.
  • Quantitative culture of endotracheal aspiration (QEA) was performed for VAP patients.
  • Minimum inhibitory concentration (MIC) of cefepime was determined using microdilution tests.

Main Results:

  • Thirty-five cases of Enterobacteriaceae were isolated, including E. coli (13), P. aeruginosa (11), Enterobacter (7), and K. pneumoniae (4).
  • High resistance rates to cefepime were observed: all E. coli, Enterobacter, and K. pneumoniae isolates were resistant.
  • 54.5% of P. aeruginosa isolates also showed full resistance to cefepime.

Conclusions:

  • Cefepime exhibits significant resistance among common VAP pathogens in this region.
  • The findings indicate that cefepime is not a reliable empirical treatment option for nosocomial pneumonia and VAP.
  • Local antimicrobial surveillance is essential for guiding empirical therapy choices.